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精神健康专业人员对男性性别对男性抑郁症治疗影响的看法——一项定性研究。

Mental health professionals view about the impact of male gender for the treatment of men with depression - a qualitative study.

机构信息

Department for Psychiatry and Psychotherapy II, Ulm University at BKH Guenzburg, Ludwig-Heilmeyer-Str. 2, 89312, Guenzburg, Germany.

Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany.

出版信息

BMC Psychiatry. 2020 Jun 3;20(1):276. doi: 10.1186/s12888-020-02686-x.

Abstract

BACKGROUND

The underestimation of depression among men may result from atypical depression symptoms and male help-seeking behaviour. However, higher suicide rates among men than among women indicate a need for gender-specific services for men with depression. In order to develop gender-specific services, it is essential to examine professionals' attitudes towards men's depressive symptoms and treatment needs as well as barriers to and facilitators of treatment. This study examined gender-specific treatment needs in male patients and treatment approaches to male patients from a professional perspective.

METHODS

Semi-structured face-to-face interviews were conducted with 33 mental health professionals (MHPs) from five German psychiatric institutions. The study assessed the characteristics and attributes of male patients with depression risk factors for the development of depression among men, their condition at the beginning of treatment, male patients' depressive symptoms, the needs and expectations of male patients, the importance of social networks in a mental health context, and MHPs' treatment aims and treatment methods. Transcripts were analysed using qualitative content analysis.

RESULTS

The professionals' reference group of male patients were men who were characterised in accordance with traditional masculinity. Attributes reported as in line with this type of men were late initiations of inpatient treatment after crisis, suicidal ideation or attempted suicide, and high expectations towards treatment duration, success rate in recovery and therapeutic sessions. In contrast, male patients who deviate from these patterns were partially described with reference to female stereotypes. Professionals referred to psychosocial models in their explanations of the causes of depression and provided sociological explanations for the development of masculine ideals among men. The consequences of these for treatment were discussed against the background of normative expectations regarding the male gender. From the professionals' point of view, psychoeducation and the acceptance of depression (as a widespread mental illness) were the most important goals in mental health treatment.

CONCLUSIONS

In order to improve mental health among men, gender-specific services should be offered. Awareness of the role of gender and its implications on mental health treatment should be an integral part of MHPs' education and their daily implementation of mental health treatment practices.

摘要

背景

男性抑郁症的低估可能是由于非典型抑郁症状和男性寻求帮助的行为所致。然而,男性自杀率高于女性,这表明需要为抑郁症男性提供特定于性别的服务。为了开发特定于性别的服务,必须检查专业人员对男性抑郁症状和治疗需求的态度,以及治疗的障碍和促进因素。本研究从专业角度检查了男性患者的特定于性别的治疗需求和对男性患者的治疗方法。

方法

对来自德国五家精神病院的 33 名心理健康专业人员(MHPs)进行了半结构化的面对面访谈。该研究评估了具有抑郁风险因素的男性患者的特征和属性、他们在治疗开始时的状况、男性患者的抑郁症状、男性患者的需求和期望、社会网络在心理健康环境中的重要性,以及 MHPs 的治疗目标和治疗方法。使用定性内容分析对转录本进行分析。

结果

专业人员的男性患者参考群体是符合传统男子气概的男性。与这种男性类型一致的特征包括在危机、自杀意念或自杀未遂后才开始住院治疗,以及对治疗持续时间、康复成功率和治疗次数的高期望。相比之下,部分偏离这些模式的男性患者则参照女性刻板印象来描述。专业人员在解释抑郁症的原因时提到了心理社会模型,并从社会学角度解释了男性中男子气概理想的发展。这些因素对治疗的影响是在关于男性性别规范期望的背景下讨论的。从专业人员的角度来看,心理健康教育和对抑郁症(作为一种常见的精神疾病)的接受是心理健康治疗最重要的目标。

结论

为了改善男性的心理健康,应提供特定于性别的服务。性别意识及其对心理健康治疗的影响应成为心理健康专业人员教育和日常实施心理健康治疗实践的一个组成部分。

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