Antidepressants, social adversity and outcome of depression in general practice

Brown, George W.; Harris, Tirril; Kendrick, Tony; Chatwin, Judy; Craig, Tom; Kelly, Vikki; Mander, Helen; Ring, Adele; Wallace, Vuokko; Uher, Rudolf

doi:10.1016/j.jad.2009.06.004

Cited by 30 publications

(23 citation statements)

References 41 publications

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“…This corresponds with the findings of Chew-Graham et al (2002) who reported that GPs perceive depression as a reaction to life events or change, and that they consider conventional clinical interventions of limited effectiveness in sociodeprived areas. Social deprivation or entrapment in aversive situations has been shown to be involved in chronic conditions in general practice (Brown et al, 2010; Kendrick, 2000; Macdonald et al, 2009). …”

Section: Discussionmentioning

confidence: 99%

What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process

Davidsen

Fosgerau

2014

International Journal of Qualitative Studies on Health and Well

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The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners’ (GPs’) treatment of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when telling stories about depressed patients. The differences were captured in three polarities which expressed the range of experiences in the two groups. Psychiatrists considered the diagnosis of depression as a pragmatic and agreed construct and they did not question its validity. GPs thought depression was a “gray area” and questioned the clinical utility in general practice. Nevertheless, GPs felt a demand from psychiatry to make their diagnosis based on instruments created in psychiatry, whereas psychiatrists based their diagnosis on clinical impression but used instruments to assess severity. GPs were wholly skeptical about instruments which they felt could be misleading. The different understandings could possibly lead to a clash of interests in any proposed CC model. The findings provide fertile ground for organizational research into the actual implementation of cooperation between sectors to explore how differences are dealt with.

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Section: Discussionmentioning

confidence: 99%

What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process

Davidsen

Fosgerau

2014

International Journal of Qualitative Studies on Health and Well

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“…In the social support literature there is now extensive evidence that the availability of compassionate social support has a major impact on resilience to distress and a range of physical and mental health indices [55]. Having access to caring and compassionate relationships buffers against the impact of negative life events on depression, and improves recovery trajectories, post-treatment functioning and relapse prevention (e.g., [8,34]). In a recent study of 632 students, Wang et al [116] found that social support significantly moderated the effect of stress on depression.…”

Section: Compassion From Othersmentioning

confidence: 99%

The development of compassionate engagement and action scales for self and others

Gilbert

Catarino

Duarte

et al. 2017

J of Compassionate Health Care

339

345

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Background: Studies of the value of compassion on physical and mental health and social relationships have proliferated in the last 25 years. Although, there are several conceptualisations and measures of compassion, this study develops three new measures of compassion competencies derived from an evolutionary, motivational approach. The scales assess 1. the compassion we experience for others, 2. the compassion we experience from others, and 3. self-compassion based on a standard definition of compassion as a 'sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it'. We explored these in relationship to other compassion scales, self-criticism, depression, anxiety, stress and well-being. Methods: Participants from three different countries (UK, Portugal and USA) completed a range of scales including compassion for others, self-compassion, self-criticism, shame, depression, anxiety and stress with the newly developed 'The Compassionate Engagement and Actions' scale.

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“…There is now good evidence from both self-report (Gilbert & Allan, 1998;Gilbert et al, 2002) and life events studies (Brown, Harris, & Hepworth, 1995;Brown et al, 2010;Kendler, Hettema, Butera, Gardner, & Prescott, 2003) that entrapment is strongly linked to depression (Kendler et al, 2003;Sturman & Mongrain 2008;Taylor et al, 2011). According to Gilbert and Allan (1998), the perception of entrapment can be triggered, amplified, and maintained by external context but also by internal processes, such as intrusive, unwanted thoughts and ruminations.…”

Section: Defensive and Arrested Behaviorsmentioning

confidence: 99%

Entrapment and Defeat Perceptions in Depressive Symptomatology: Through an Evolutionary Approach

Carvalho

Pinto‐Gouveia²,

Pimentel³

et al. 2013

Psychiatry: Interpersonal and Biological Processes

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The social rank and arrested defenses model for mood disorders bridges between animal and human models of psychopathology. There is increasing evidence that depression is associated with subordinated and loss of social rank, feeling inferior, shame, submissive behavior, and feeling defeated. These stressful states activate threat coping responses of fight and flight. If these are aroused but blocked, feelings of entrapment emerge with a negative impact on mood. The current study builds on previous studies and explores the association between depressive symptoms, social rank variables (of social comparison and submissive behavior), entrapment, and defeat in a sample of patients (n = 106) with major depression and in a sample of healthy controls (n = 116). Results showed that social rank variables, entrapment, and defeat were strongly associated with depressive symptoms in both samples. Entrapment and defeat showed significant association with other social rank variables. Logistic regression analysis revealed that defeat and internal entrapment were significant predictors of the belonging to the clinical or control groups. The present study extends previous research and supports the importance of defeat and external entrapment in clinical depression.

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Antidepressants, social adversity and outcome of depression in general practice

Cited by 30 publications

References 41 publications

What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process

What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process

The development of compassionate engagement and action scales for self and others

Entrapment and Defeat Perceptions in Depressive Symptomatology: Through an Evolutionary Approach

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