Research Division, Institute of Mental Health, Singapore, Singapore.
Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore.
PLoS One. 2021 Jun 9;16(6):e0252913. doi: 10.1371/journal.pone.0252913. eCollection 2021.
Illness perceptions form a key part of common-sense models which are used widely to explain variations in patient behaviours in healthcare. Despite the pervasiveness of depressive disorders worldwide and in young adults, illness perceptions of depressive disorders have not yet been well understood. Moreover, while a high proportion of cases of depressive disorders reside in South-east Asia, few have explored illness perceptions that are culturally relevant to this region. To address these limitations, this study aimed to understand illness perceptions of young adults diagnosed with depressive disorders. Face-to-face semi-structured interviews were conducted among Chinese, Malay, and Indian young adults aged 20 to 35 years old, who were seeking treatment at a psychiatric hospital. Data reached saturation after 33 interviews (10 to 12 interviews per ethnic group) and five themes emerged from the thematic analysis: 1) A reduced state of being experienced at a point of goal disengagement, 2) the accumulation of chronic stressors in a system that demands success and discourages the pursuit of personally meaningful goals, 3) a wide range of symptoms that are uncontrollable and disabling, 4) poor decision making resulting in wasted opportunities, with some positive takeaways, and 5) accepting the chronicity of depression. Young adults typically experienced depression as a reduced state of being and it was thought of cognitively as an entity that may be a part of or separate from the self. Over and beyond these aspects of cognitive representations was the emergence of themes depicting conflicts and dilemmas between the self and the social environment that threatened self-identity and autonomy. Addressing these conflicts in therapy would therefore be of utmost relevance for young adults recovering from depressive disorders in the local setting.
疾病认知构成了常识模型的关键部分，这些模型被广泛用于解释医疗保健中患者行为的变化。尽管全球和年轻人中抑郁障碍普遍存在，但对抑郁障碍的疾病认知还没有得到很好的理解。此外，尽管抑郁障碍的很大一部分病例存在于东南亚，但很少有研究探讨与该地区文化相关的疾病认知。为了解决这些限制，本研究旨在了解被诊断患有抑郁障碍的年轻人的疾病认知。对年龄在 20 至 35 岁之间的中国、马来和印度年轻人进行了面对面的半结构化访谈，他们正在一家精神病院接受治疗。在 33 次访谈（每个族裔群体 10-12 次访谈）后，数据达到饱和，主题分析得出了五个主题：1）在目标脱离时体验到的一种状态降低，2）在一个要求成功且不鼓励追求个人有意义目标的系统中积累的慢性压力源，3）一系列不可控和致残的广泛症状，4）导致错失机会的不良决策，但也有一些积极的收获，5）接受抑郁的慢性。年轻人通常将抑郁体验为一种状态降低，并且从认知上认为它是一种可能是自我的一部分或与自我分开的实体。在这些认知表现的方面之外，还出现了一些主题，描绘了自我和社会环境之间的冲突和困境，这些冲突和困境威胁到自我认同和自主性。因此，在当地环境中，从抑郁中恢复的年轻人的治疗中解决这些冲突将是至关重要的。
