Bouhuys A L, Van den Hoofdakker R H
Department of Biological Psychiatry, University Psychiatric Clinic, Groningen, The Netherlands.
J Affect Disord. 1993 Feb;27(2):87-99. doi: 10.1016/0165-0327(93)90081-t.
Observed behaviour of a psychiatrist interacting with severely depressed patients during an interview was related to the course of depression during hospitalization. The behavioural structure of such interaction could be described by 6 factors for the patients and 7 factors for the psychiatrist. The study focuses on the psychiatrist's behaviour. The severity of depression and the level of the behaviour factors were assessed just after admission (drug-free) and 10 weeks later. Patients were divided a posteriori into non-improved patients (N = 13) and improved patients (N = 18). The psychiatrist displayed low levels of 'active-listening' (intensive body touching and other hand movements during listening) and showed a tendency to more 'encouragement' by use of remarks such as hm, yes, and head-nodding) in his interaction with patients who did not improve. These factors did not change over time, suggesting that they may play a role in the maintenance of depression. They are supposed to express involvement, and probably indicate psychiatrist's giving support to the support-seeking patients. At the same time the psychiatrist exhibited an aversive response to the non-improved patients, by showing higher frequencies of looking away during his encouragement. The results provide support for interactional theories on depression and illustrate the possible value of an ethological approach in the study of interactional processes.
观察到精神科医生在访谈期间与重度抑郁症患者互动的行为与住院期间抑郁症的病程有关。这种互动的行为结构可以用患者的6个因素和精神科医生的7个因素来描述。该研究聚焦于精神科医生的行为。在入院时（未用药）和10周后对抑郁症的严重程度和行为因素水平进行了评估。患者事后被分为未改善组（N = 13）和改善组（N = 18）。精神科医生在与未改善的患者互动时表现出较低水平的“积极倾听”（倾听时频繁的身体接触和其他手部动作），并表现出更多使用诸如“嗯”“是的”以及点头等言语进行“鼓励”的倾向。这些因素不会随时间变化，这表明它们可能在抑郁症的维持中起作用。它们被认为表达了参与，可能表明精神科医生对寻求支持的患者给予支持。同时，精神科医生对未改善的患者表现出厌恶反应，在鼓励过程中看向别处的频率更高。这些结果为抑郁症的互动理论提供了支持，并说明了行为学方法在研究互动过程中的可能价值。
