Nosek Margaret A, Hughes Rosemary B, Robinson-Whelen Susan
Center for Research on Women with Disabilities, Baylor College of Medicine, PO Box 890286, Houston, Texas 77289, USA.
Disabil Rehabil. 2008;30(3):174-83. doi: 10.1080/09638280701532219.
This article discusses the complex interrelation of elements of the physical, psychological, social, and environmental life context of women with physical disabilities and the association of these elements with significant disparities in rates of depression and access to mental health care for this population.
Literature and concept review.
High rates of depression in women with physical disabilities are well documented in the literature. Many elements that are disproportionately common in the lives of women with physical disabilities, including socio-economic disadvantage, functional limitations, pain and other chronic health conditions, poor diet, physical inactivity, smoking, violence, low self-esteem, sexuality problems, chronic stress, environmental barriers, and barriers to health care, have also been linked with higher rates of depression and depressive symptomatology. Depression self-management interventions tailored for women with disabilities have been developed and proven effective.
Many women who must deal with the stresses surrounding an array of health problems may experience symptoms of depression without necessarily meeting the criteria for clinical depression. Psychologists, counselors, primary care physicians, specialists, and other medical and rehabilitation professionals are challenged to recognize the symptoms of depression in women with physical disabilities and assist them in obtaining appropriate psychological and pharmacological interventions.
本文探讨身体残疾女性在身体、心理、社会和环境生活背景方面各要素之间的复杂相互关系，以及这些要素与该人群抑郁症发病率和心理健康护理可及性方面显著差异的关联。
文献及概念综述。
身体残疾女性中抑郁症的高发病率在文献中有充分记载。许多在身体残疾女性生活中不成比例地普遍存在的因素，包括社会经济劣势、功能限制、疼痛及其他慢性健康状况、不良饮食、缺乏身体活动、吸烟、暴力、低自尊、性问题、慢性压力、环境障碍以及医疗保健障碍等，也都与较高的抑郁症发病率和抑郁症状有关。已经开发出针对残疾女性的抑郁症自我管理干预措施并证明其有效。
许多必须应对一系列健康问题所带来压力的女性可能会出现抑郁症状，但不一定符合临床抑郁症的标准。心理学家、顾问、初级保健医生、专科医生以及其他医疗和康复专业人员面临的挑战是，识别身体残疾女性的抑郁症状，并协助她们获得适当的心理和药物干预。
