青少年抑郁症治疗康复过程中面临困境的质性研究

云文洁; 刘梦琪; 陈旭; 褚红玲; 汪海波

doi:10.16835/j.cnki.1000-9817.2023.07.028

青少年抑郁症治疗康复过程中面临困境的质性研究

doi: 10.16835/j.cnki.1000-9817.2023.07.028

云文洁^{1, 2, 3},
刘梦琪⁴,
陈旭⁴,
褚红玲⁵,
汪海波^{1, 2, 3, ,}

1.
北京大学第一临床医学院, 北京 100191
2.
北京大学临床研究所
3.
重大疾病流行病学教育部重点实验室(北京大学)
4.
首都医科大学附属北京安定医院/国家精神心理疾病临床医学研究中心/精神疾病诊断与治疗北京市重点实验室
5.
北京大学第三医院临床流行病学研究中心

基金项目:

2021年科技部科技创新2030"脑科学与类脑研究" 重大项目 2021ZD0200600

详细信息

作者简介:
云文洁(1995-)，女，内蒙古呼和浩特人，在读硕士，主要研究方向为青少年心理卫生

通讯作者:
汪海波，E-mail：hbwang2005@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 R179 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2023-02-22
- 修回日期: 2023-05-04
- 网络出版日期: 2023-07-25
- 刊出日期: 2023-07-25

A qualitative study of the difficulties faced by adolescents with depression in the treatment and rehabilitation

YUN Wenjie^{1, 2, 3},
LIU Mengqi⁴,
CHEN Xu⁴,
CHU Hongling⁵,
WANG Haibo^{1, 2, 3
, ,}

1.
The First Clinical Medical College, Peking University, Beijing(100191), China

摘要

摘要: 目的基于质性研究方法，探讨青少年抑郁症治疗康复过程中的消极体验，挖掘患者面临的真实困境，为促进中国青少年抑郁症治疗体系完善提供参考。方法 2022年8—11月采用目的抽样法，在首都医科大学附属北京安定医院儿童青少年精神病科住院部选取30名抑郁症青少年进行深度访谈，运用Colaizzi七步法对访谈数据进行分析，归纳出主题。结果青少年抑郁症疾病治疗康复过程中面临的真实困境可归纳为3个主题和6个子主题：家庭应对不当(照顾者缺乏正确的疾病认知；照顾者缺乏有效的应对手段)、疾病诊疗困难(识别率低，治疗效果差；医疗服务需求不能满足)、继续学业障碍(学业进展障碍；人际关系障碍)。结论青少年抑郁症在疾病治疗康复过程中面临着家、校、医疗等方面困境。应提高照顾者的疾病素养和照护技能，建立家庭、学校、社区、医疗机构多方协作的疾病管理体系，促进青少年抑郁症治疗和社会功能恢复。
- 抑郁症 /
- 精神卫生 /
- 质性研究 /
- 青少年
Abstract: Objective Based on a qualitative research method, the present study aims to explore the negative experiences and real dilemmas of adolescent with depression in the treatment and rehabilitation process, so as to provide references to promote the improvement of the treatment system for adolescent depression in China. Methods From August 2022 to November 2022, 30 adolescents with depression were selected for in-depth interviews in the inpatient department of child and adolescent psychiatry at Beijing An Ding Hospital affiliated with Capital Medical University by using the purposive sampling method, and the interview data were analyzed by using the Colaizzi method to summarize the themes. Results The real dilemmas faced by depressed adolescent during treatment and recovery included three aspects: inappropriate family coping (caregivers' lacking of correct disease cognition; caregivers' lacking of effective coping methods), difficulties in disease diagnosis and treatment (low rate of identification and adverse effect of treatment; medical service failing to satisfy the demands), and barriers to continued schooling (barriers to academic progress and interpersonal communication). Conclusion Adolescents with depression face real dilemmas in the process of disease treatment and rehabilitation at home, school and medical care. Caregivers' disease literacy and caregiving skills should be improved. A collaborative disease management system among family, school, community and medical institutions should be established to promote adolescent depression treatment and social function recovery.
- Depression disorder /
- Mental health /
- Qualitative research /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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参考文献(26)

[1]	CLAYBORNE Z M, VARIN M, COLMAN I. Systematic review and Meta-analysis: adolescent depression and long-term psychosocial outcomes[J]. J Am Acad Child Adolesc Psychiatry, 2019, 58(1): 72-79. doi: 10.1016/j.jaac.2018.07.896
[2]	JOHNSON D, DUPUIS G, PICHE J, et al. Adult mental health outcomes of adolescent depression: a systematic review[J]. Depress Anx, 2018, 35(8): 700-716. doi: 10.1002/da.22777
[3]	DEY M, CASTRO R P, HAUG S, et al. Quality of life of parents of mentally-ill children: a systematic review and Meta-analysis[J]. Epidemiol Psychiatr Sci, 2019, 28(5): 563-577. doi: 10.1017/S2045796018000409
[4]	ZHONG B, DING J, CHEN H, et al. Depressive disorders among children in the transforming China: an epidemiological survey of prevalence, correlates, and service use[J]. Depress Anxiety, 2013, 30(9): 881-892. doi: 10.1002/da.22109
[5]	SHOREY S, NG E D, WONG C H J. Global prevalence of depression and elevated depressive symptoms among adolescents: a systematic review and Meta-analysis[J]. Br J Clin Psychol, 2022, 61(2): 287-305. doi: 10.1111/bjc.12333
[6]	RAPP A M, CHAVIRA D A, SUGAR C A, et al. Incorporating family factors into treatment planning for adolescent depression: perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care Trial[J]. J Affect Disord, 2021, 278: 46-53. doi: 10.1016/j.jad.2020.09.028
[7]	PARHIALA P, MARTTUNEN M, GERGOV V, et al. Predictors of outcome after a time-limited psychosocial intervention for adolescent depression[J]. Front Psychol, 2022, 13: 955261. doi: 10.3389/fpsyg.2022.955261
[8]	GOODYER I M, WILKINSON P O. Practitioner review: therapeutics of unipolar major depressions in adolescents[J]. J Child Psychol Psychiatry, 2019, 60(3): 232-243. doi: 10.1111/jcpp.12940
[9]	BEAR H A, EDBROOKE-CHILDS J, NORTON S, et al. Systematic review and Meta-analysis: outcomes of routine specialist mental health care for young people with depression and/or anxiety[J]. J Am Acad Child Adolesc Psychiatry, 2020, 59(7): 810-841. doi: 10.1016/j.jaac.2019.12.002
[10]	EDBROOKE-CHILDS J, WOLPERT M, ZAMPERONI V, et al. Evaluation of reliable improvement rates in depression and anxiety at the end of treatment in adolescents[J]. BJ Psych Open, 2018, 4(4): 250-255.
[11]	世界卫生组织. ICD-10精神与行为障碍分类临床描述与诊断要点[M]. 范肖冬, 译. 北京: 人民卫生出版社, 1993: 50-55. WHO. Clinical description and diagnosis points of ICD-10 psychiatric and behavioral disorder classification[M]. FAN X D, translated. Beijing: People's Medical Publishing House, 1993: 50-55. (in Chinese)
[12]	刘明. Colaizzi七个步骤在现象学研究资料分析中的应用[J]. 护理学杂志, 2019, 34(11): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201911031.htm LIU M. Using an example to illustrate Colaizzi's phenomenological data analysis method[J]. J Nurs Sci, 2019, 34(11): 90-92. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ201911031.htm
[13]	HOWARD K R, REINECKE M A, LAVIGNE J V, et al. Marital and parent-child relationships during treatment for adolescent depression: child-driven and bidirectional effects[J]. J Abnorm Child Psychol, 2019, 47(11): 1841-1850. doi: 10.1007/s10802-019-00566-x
[14]	SHEEBER L, HOPS H, ANDREWS J, et al. Interactional processes in families with depressed and non-depressed adolescents: reinforcement of depressive behavior[J]. Behav Res Ther, 1998, 36(4): 417-427. doi: 10.1016/S0005-7967(97)10030-4
[15]	CHIANG S C, BAI S. Reciprocal influences among marital relationship, parent-adolescent relationship, and youth depressive symptoms[J]. J Marri Fam, 2022, 84(4): 962-981. doi: 10.1111/jomf.12836
[16]	PATEL V, XIAO S, CHEN H, et al. The magnitude of and health system responses to the mental health treatment gap in adults in India and China[J]. Lancet, 2016, 388(10063): 3074-3084. doi: 10.1016/S0140-6736(16)00160-4
[17]	LIANG D, MAYS V M, HWANG W C. Integrated mental health services in China: challenges and planning for the future[J]. Health Policy Plan, 2018, 33(1): 107-122. doi: 10.1093/heapol/czx137
[18]	LU J, XU X, HUANG Y, et al. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2021, 8(11): 981-990. doi: 10.1016/S2215-0366(21)00251-0
[19]	ALBRIGHT K, BARNARD J, O'LEARY S, et al. School-based health centers as medical homes: parents' and adolescents' perspectives[J]. Acad Pediatr, 2016, 16(4): 381-386. doi: 10.1016/j.acap.2015.06.004
[20]	赵献梓, 王剑彪. 学校心理健康教育结合家庭干预对中学生心理健康的影响[J]. 中国学校卫生, 2021, 42(3): 408-411. doi: 10.16835/j.cnki.1000-9817.2021.03.022 ZHAO X Z, WANG J B. Influence of school mental health education combined with family intervention on the mental health of middle school students[J]. Chin J Sch Health, 2021, 42(3): 408-411. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.03.022
[21]	PERRY Y, PETRIE K, BUCKLEY H, et al. Effects of a classroom-based educational resource on adolescent mental health literacy: a cluster randomised controlled trial[J]. J Adolesc, 2014, 37(7): 1143-1151. doi: 10.1016/j.adolescence.2014.08.001
[22]	PINTO-FOLTZ M D, LOGSDON M C, MYERS J A. Feasibility, acceptability, and initial efficacy of a knowledge-contact program to reduce mental illness stigma and improve mental health literacy in adolescents[J]. Soc Sci Med, 2011, 72(12): 2011-2019. doi: 10.1016/j.socscimed.2011.04.006
[23]	马帅帅, 宋杨肖, 孙莹. 以学校为基础的儿童青少年心理健康促进干预研究进展[J]. 中国学校卫生, 2022, 43(5): 685-689. doi: 10.16835/j.cnki.1000-9817.2022.05.011 MA S S, SONG Y X, SUN Y. Research updates of school-based intervention for mental health promotion among children and adolescents[J]. Chin J Sch Health, 2022, 43(5): 685-689. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.05.011
[24]	范福林, 王乃弋, 王工斌. 中小学心理教师专业化现状调查及发展探究[J]. 教育学报, 2013, 9(6): 91-101. https://www.cnki.com.cn/Article/CJFDTOTAL-XKJY201306015.htm FAN F L, WANG N G, WANG G B. The investigation of the status quo of professional development of psychological teachers in elementary and secondary schools and the exploration of their future development[J]. J Educ Stud, 2013, 9(6): 91-101. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XKJY201306015.htm
[25]	方姣, 孙莹, 陶芳标. 改革开放以来我国学校心理卫生服务的发展历程与困境突破[J]. 中国学校卫生, 2019, 40(9): 1281-1285, 1288. doi: 10.16835/j.cnki.1000-9817.2019.09.001 FANG J, SUN Y, TAO F B. The development process and the breakthrough in the difficulties of the school mental health service in China since the reform and opening up[J]. Chin J Sch Health, 2019, 40(9): 1281-1285, 1288. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.09.001
[26]	张微, 张宛筑, 袁章奎. 贵阳市中小学心理卫生服务现状[J]. 中国学校卫生, 2019, 40(2): 305-307. doi: 10.16835/j.cnki.1000-9817.2019.02.042 ZHANG W, ZHANG Y Z, YUAN Z K. Status quo of mental health services in primary and secondary schools in Guiyang City[J]. Chin J Sch Health, 2019, 40(2): 305-307. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.02.042