Limenih Gojjam, MacDougall Arlene, Smith Max Well J, Nouvet Elysee
Faculty of Health Sciences, Western University, London, ON, Canada.
St. Joseph Health Care, London, ON, Canada.
Int J Soc Psychiatry. 2025 Feb;71(1):78-89. doi: 10.1177/00207640241280620. Epub 2024 Oct 18.
Depression is a global crisis and a major concern in mental health interventions, particularly in low- and middle-income countries (LMICs), where it significantly impacts disability, quality of life, and economic stability. These chronic stressors have been used to argue for scaling up the detection and treatment of depression as a public health and development priority.
This study aimed to explore illness narratives of depression among patients' and to gain insights into multifaceted suffering, its impact on persons' lives, and help seeking. This study is part the broader study which examined global mental health, biopolitics, and depression in Ethiopia, conducted in hospice setting to explore the conception of depression in Bahirdar city, Northern Ethiopia, among patients and health care providers. In this study, we focus on patients' accounts of depression.
We employed an ethnography method using in-depth interviews, fieldnotes, and observation to collect the data. A thematic analysis was used to analyze the data. Drawing from cross-cultural and critical psychiatry perspectives, we situate depression within its cultural-eco social framework.
The study revealed that patients' experiences and conception of depression are deeply intertwined with Ethiopia's sociocultural, economic, and spiritual context. Depression was often described as a state of being 'impaired in life', reflecting the complex interplay of individual struggles and societal pressures. Integrating quotes from patients, we demonstrated in this analysis the ways in which biographically specific challenges, societal pressures, and mental well-being are understood by study participants in accordance with Ethiopian cultural and religious norms.
The study suggests moving beyond narrow interpretative frameworks in GMH praxis to understand and address the complex dimensions of depression in Ethiopia and similar contexts. The study advocates for a cultural-ecosocial approach to depression, emphasizing the need for mental health interventions that consider the broader social and cultural factors contributing to mental distress.
抑郁症是一场全球危机，也是心理健康干预领域的主要关注点，在低收入和中等收入国家（LMICs）尤其如此，抑郁症对残疾、生活质量和经济稳定产生了重大影响。这些慢性应激源被用来支持将扩大抑郁症的检测和治疗作为公共卫生和发展的优先事项。
本研究旨在探索患者中抑郁症的疾病叙事，并深入了解多方面的痛苦、其对人们生活的影响以及寻求帮助的情况。本研究是一项更广泛研究的一部分，该研究在埃塞俄比亚的临终关怀环境中探讨了全球心理健康、生物政治学和抑郁症，以探究埃塞俄比亚北部巴赫达尔市患者和医疗服务提供者对抑郁症的概念。在本研究中，我们关注患者对抑郁症的描述。
我们采用人种志方法，通过深入访谈、实地记录和观察来收集数据。采用主题分析法对数据进行分析。从跨文化和批判性精神病学的角度出发，我们将抑郁症置于其文化 - 生态社会框架内。
研究表明，患者对抑郁症的体验和概念与埃塞俄比亚的社会文化、经济和精神背景紧密相连。抑郁症常被描述为一种“生活受损”的状态，反映了个人挣扎与社会压力的复杂相互作用。在本分析中，我们整合了患者的引述，展示了研究参与者如何根据埃塞俄比亚的文化和宗教规范理解特定人生经历中的挑战、社会压力和心理健康。
该研究表明，在全球心理健康实践中应超越狭隘的解释框架，以理解和应对埃塞俄比亚及类似背景下抑郁症的复杂层面。该研究倡导采用文化 - 生态社会方法来应对抑郁症，强调心理健康干预需要考虑导致心理困扰的更广泛社会和文化因素。
