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青少年抑郁症诊断经历:巴西的一项定性初步研究

The experience of receiving a diagnosis of depression in adolescence: A pilot qualitative study in Brazil.

作者信息

Viduani Anna, Benetti Silvia, Petresco Sandra, Piccin Jader, Velazquez Bruna, Fisher Helen L, Mondelli Valeria, Kohrt Brandon A, Kieling Christian

机构信息

Department of Psychiatry, 28124Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 4616King's College London, UK.

出版信息

Clin Child Psychol Psychiatry. 2022 Jul;27(3):598-612. doi: 10.1177/13591045211063494. Epub 2022 Feb 14.

Abstract

Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents' initial reactions after receiving a clinical diagnosis of Major Depressive Disorder in the context of a neurobiological study of depression in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and neuroimaging study, in which they were given a diagnosis of depression, and in a follow-up visit 2 weeks later. Interviews were designed to explore the subjective experience of receiving the diagnosis and the impacts of depression on adolescents' lives. Framework Analysis was used to analyze the accounts. Diagnosis was perceived as a reification of an abnormal status, highlighting the role of stigma and the process of disclosing the diagnosis to others. Adolescents reported the multiple sensemaking processes that occurred when they received a diagnosis of depression, and most struggled with the idea that negative emotions would equate their experience with a disorder. The results show that future efforts could enhance clinical assessment processes with adolescents by exploring adolescents' reactions to diagnosis, as well as the support networks available to them, resulting in increased help-seeking behaviors, and diminished social and personal stigma.

摘要

被诊断为抑郁症会对青少年的生活产生重大影响。然而,关于青少年如何应对、赋予心理健康诊断何种意义以及如何理解这些诊断的信息却很有限。本研究的目的是在巴西一项抑郁症神经生物学研究的背景下,探讨青少年在被临床诊断为重度抑郁症后的初始反应。采用定性设计,对八名巴西青少年进行了两次访谈:一次是在精神病学评估和神经影像学研究后立即进行,在这次评估中他们被诊断为抑郁症;另一次是在两周后的随访中进行。访谈旨在探讨接受诊断的主观体验以及抑郁症对青少年生活的影响。采用框架分析法对访谈记录进行分析。诊断被视为异常状态的具体化,凸显了污名的作用以及向他人透露诊断结果的过程。青少年报告了他们在被诊断为抑郁症时所经历的多种意义建构过程,大多数人难以接受负面情绪会将他们的经历等同于一种疾病的观念。结果表明,未来的努力可以通过探索青少年对诊断的反应以及他们可利用的支持网络来加强对青少年的临床评估过程,从而增加求助行为,并减少社会和个人污名。

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