BackgroundAdolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible.MethodsWe recruited 105 young persons (17–21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups.ResultsParticipants’ reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services.ConclusionsA better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context.

Background Depression affects a considerable proportion (12–25 %) of adolescents and so-called emerging adults (ages of 18 and 25). The aims of this study were to explore the relationship between perceived social support and depression in a sample of emerging adults, and subsequently to identify the type of social support young people consider most helpful in dealing with this type of emotional distress.MethodsA sample of 105 young persons (17–21 years of age) was selected from a previous longitudinal study to create three groups of participants: subjects with a previous diagnosis of depression; subjects with self-perceived but undiagnosed distress compatible with depression; and a group of controls. Qualitative and validated instruments for measuring depressive symptoms (the BDI-II, Beck depression inventory) and social support (the Mannheim interview on social support) were administered.ResultsLoss of friendships over time and dissatisfaction with social and psychological support are variables associated with depression in emerging adulthood. Qualitative analysis revealed gender differences both in strategies for managing distress, and in how social support was understood to mitigate depressive symptoms. Male study participants prioritized support that helped them achieve self-control as a first step toward awareness of their emotional distress, while female study participants prioritized support that helped them achieve awareness of the problem as a first step toward self-control.ConclusionsTreatment for emerging adults with depression should take into account not only the impact of social support, but also gender differences in what they consider to be the most appropriate form of social support for dealing with emotional distress.Electronic supplementary materialThe online version of this article (doi:10.1186/s13034-015-0088-x) contains supplementary material, which is available to authorized users.

A brief excursion through the history of social medicine suggests that, at least in principle, epidemiology and anthropology are natural allies in the study of disease in human populations. In practice, however, this alliance has been limited and remains problematic. This article examines the possibilities for interdisciplinary research, taking cancer epidemiology as a case in point. I argue, on the basis of participant-observation over a period of nearly two years in the epidemiology department of a medical research institute in Catalonia (Spain), that bioscientific uses of the concept of culture have led, disappointingly, to its reification as "beliefs" and its incorporation into the naturalist epistemology of Western institutional medicine. The unfortunate consequence is the medicalization of culture understood as "difference," which often stands in for social class.

The search for a synthesis bridging the gap between materialist and idealist approaches in anthropological theory has been invigorated by recent efforts to develop a critical medical anthropology. Not limited to integrating class analysis and cultural interpretation, the "mindful body" paradigm also aims at empowering the ill, whose experience is denied by biomedical and psychiatric categories that locate disease either in the body or in the mind, and treat them separately from one another and independently of social context. However, missing from the "mindful body" discourse is a reflexive awareness of its contextual grounding in both popular and biomedical discourses of illness, with which it exchanges meanings and from which it borrows dominating power. The case of cancer as a metaphorized illness and a pathologized trope is used to illustrate this process.

Background: Many randomized controlled trials (RCTs) of acupuncture reveal no significant differences between acupuncture and so-called placebo acupuncture. There is a strong tendency to replace the term “placebo” by the term “sham,” because any needling stimulates a certain physiological response. However, neither concept accounts for the great diversity of results in RCTs comparing verum acupuncture and sham (placebo) acupuncture. Some trials have shown little or no difference, while other studies have found statistically significant differences. Objective: Verum acupuncture and sham (placebo) acupuncture may achieve similar results to the extent that they share active constituents. We identified these common active constituents as dermatomes: the segmental structure of the human body. In our study, we tested the hypothesis that the more verum and sham (placebo) acupuncture share the same dermatomes, the closer the clinical outcomes will be, and vice versa. Methods: All major databases were searched for RCTs that tested acupuncture versus sham (placebo) acupuncture. The dermatome charts of Hansen and Schliack were used to verify verum and sham (placebo) needling locations. Reported clinical outcomes were assessed in relation to the percentage of overlap between the dermatomes stimulated by acupuncture and sham (placebo) acupuncture. Results: Our literature search yielded a total of 1738 references. Thirty-four studies met the inclusion criteria. The effects of sham (placebo) acupuncture varied according to the dermatomes stimulated: high overlap with those stimulated by verum acupuncture resulted in almost identical efficacy, while low overlap resulted in significant differences in efficacy. Clinical outcomes were similar when verum acupuncture and sham (placebo) acupuncture shared the same dermatomes (p < 0.01). Discussion: The findings of this review confirm our hypothesis. Acupuncture studies that employed verum and sham locations on overlapping dermatomes helped to create a mediocre to negative picture of acupuncture’s efficacy. The segmental structure of the body with its interconnected reflex system offers an additional neurophysiological explanation for the effectiveness of acupuncture applied to structures segmentally innervated by the spinal and visceral nervous system. Further comparative acupuncture studies should be based on knowledge of segmental anatomy. In testing verum acupuncture versus sham acupuncture, the chosen sham acupuncture needling locations should be situated on non-overlapping dermatomes.