Ekbäck Erik, Strömbäck Maria, Rådmark Lina, Öjebrandt Johan, Molin Jenny, Henje Eva
Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
Scand J Child Adolesc Psychiatr Psychol. 2024 Oct 17;12(1):63-71. doi: 10.2478/sjcapp-2024-0007. eCollection 2024 Jan.
Depression is common and increasing in young people, who seem especially vulnerable, both in the probability of developing depression, and in the resulting negative consequences across the lifespan. Unfortunately, available treatments rarely lead to full remission and even in cases of remission relapse rates are high. Different explanatory models have been proposed, and research indicates a multifaceted etiology. The descriptive DSM-5 has low diagnostic validity in this age-group, especially for depressive disorders, and limited attention has been given to young people's own experiences of becoming depressed. Hence, there is a risk of missing clinical information that is important for the therapeutic alliance and treatment.
This study aimed to explore young people's experiences of becoming depressed.
A qualitative study was performed. Six participants with clinical depression, currently in treatment at child and adolescent psychiatric outpatient clinics in northern Sweden were recruited. Interviews followed a semi-structured manual, and data was analyzed with inductive qualitative content analysis.
Participants described different reasons for their depression, and from their stories four categories were identified: "Being subjected to violence", "Suffering separation and loss", "Feeling abandoned", and "Feeling burdened and vulnerable". These categories were interpreted in the theme: "Dealing with an overwhelming life situation".
The participants presented mainly stressful external and relational events preceding their depression. A combination of overwhelming stressors, lack of support and lack of time for recovery was described. This points to the importance of validating the narratives of young patients with depression and to offer trauma-informed treatment approaches in mental health care.
抑郁症在年轻人中很常见且呈上升趋势,他们在患抑郁症的可能性以及由此产生的贯穿一生的负面后果方面似乎特别脆弱。不幸的是,现有的治疗方法很少能导致完全缓解,即使在缓解的情况下复发率也很高。已经提出了不同的解释模型,研究表明病因是多方面的。描述性的《精神疾病诊断与统计手册》第五版(DSM - 5)在这个年龄组的诊断效度较低,尤其是对于抑郁症,而且对年轻人自身抑郁经历的关注有限。因此,存在遗漏对治疗联盟和治疗很重要的临床信息的风险。
本研究旨在探索年轻人的抑郁经历。
进行了一项定性研究。招募了六名患有临床抑郁症且目前正在瑞典北部儿童和青少年精神科门诊接受治疗的参与者。访谈遵循半结构化手册,并采用归纳定性内容分析法对数据进行分析。
参与者描述了他们抑郁的不同原因,从他们的故事中确定了四个类别:“遭受暴力”、“经历分离和丧失”、“感到被抛弃”以及“感到负担沉重和脆弱”。这些类别在主题“应对压倒性的生活状况”中得到了解释。
参与者主要讲述了在抑郁之前发生的压力巨大的外部和人际关系事件。描述了压倒性压力源、缺乏支持和缺乏恢复时间的综合情况。这表明在精神卫生保健中验证抑郁症年轻患者的叙述并提供创伤知情治疗方法的重要性。