Sánchez Guerrero H Andrés, Wessing Ida
Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Münster, Münster, Germany.
Front Psychol. 2024 Feb 23;15:1322328. doi: 10.3389/fpsyg.2024.1322328. eCollection 2024.
Researchers are increasingly acknowledging that psychopathological conditions usually grouped together under the generic label "depression" are highly diverse. However, no differential therapeutic approach currently exists that is sensitive to the varieties of depression afflicting young people. In fact, the discussion is missing something much more fundamental: a specification of the types of adolescent depression. Recent research that has aimed to classify different kinds of depression has mainly studied adult populations and predominantly used technically complicated measurements of biological markers. The neglect of the potential particularities of dysphoric disorders affecting youths is unfortunate, and the exclusive focus on biological parameters unnecessarily restrictive. Moreover, this one-sidedness obfuscates more directly available sources of clinically relevant data that could orient conceptualization efforts in child and adolescent psychiatry. Particularly, clues for discriminating different types of adolescent depression may be obtained by analyzing personally articulated accounts of how affected young people experience changes in their relation to the world and to themselves. Thus, here we present and discuss the findings of a study that explored the possibility of specifying types of adolescent depression in a phenomenological way. The study investigated the association between these types and the vicissitudes of personality development. In accounts given by youths diagnosed with depression during semi-structured interviews, we identified themes and examined their phenomenological centrality. Specifically, our qualitative analyses aimed to determine the relative importance of certain themes with respect to the overall intelligibility of the described changes to the relational space. Based on the findings of these analyses, we differentiate three specifiers of adolescent depression and suggest an association between particular types of experiences and the trajectory of affected adolescents' personality development. To our knowledge, this is the first phenomenologically grounded specification of types of adolescent depression with potential therapeutic significance. Thus, based on this contribution, we propose that modes of scientific exploration that are close to phenomenological philosophy-which have been ignored in the context of developmental psychopathology-could offer a foundation to theories developed in the field of child and adolescent psychiatry.
研究人员越来越认识到,通常归在“抑郁症”这一通用标签下的精神病理状况具有高度多样性。然而,目前不存在对困扰年轻人的各类抑郁症敏感的差异化治疗方法。事实上,讨论中遗漏了一些更根本的东西:青少年抑郁症类型的具体说明。近期旨在对不同类型抑郁症进行分类的研究主要针对成年人群体,并且主要使用技术复杂的生物标志物测量方法。忽视影响青少年的烦躁症潜在的特殊性是不幸的,而仅关注生物学参数的做法限制过多。此外,这种片面性更直接地掩盖了临床上相关数据的可用来源,而这些数据本可指导儿童和青少年精神病学的概念化工作。特别是,通过分析受影响的年轻人如何描述他们与世界及自身关系变化的个人叙述,可能获得区分不同类型青少年抑郁症的线索。因此,在此我们展示并讨论一项研究的结果,该研究探索了以现象学方式明确青少年抑郁症类型的可能性。该研究调查了这些类型与人格发展变迁之间的关联。在对被诊断为抑郁症的青少年进行的半结构化访谈中,我们识别出主题并考察了它们的现象学核心地位。具体而言,我们的定性分析旨在确定某些主题相对于所描述的关系空间变化的总体可理解性的相对重要性。基于这些分析结果,我们区分出青少年抑郁症的三个具体说明,并提出特定类型的经历与受影响青少年的人格发展轨迹之间的关联。据我们所知,这是首个具有潜在治疗意义的基于现象学的青少年抑郁症类型说明。因此,基于这一贡献,我们提出在发展精神病理学背景下被忽视的接近现象学哲学的科学探索模式,可为儿童和青少年精神病学领域的理论发展提供基础。