Phenomenological descriptions of depressed mental life offer a profound understanding of depression from the first-person perspective. In this paper, such descriptions are developed by drawing on the work by Ludwig Binswanger and on the autobiographical report of depression by Piet C. Kuiper . I will argue that Binswanger’s central claim in his phenomenological description of the depressed state of mind fails due to crucial misunderstandings of Edmund Husserl’s phenomenology. Nonetheless, by drawing on Kuiper’s first-hand account, I will develop a (...) phenomenological description of depressed mental life, highlighting the altered manner of pre-reflective valuing in depression and introducing the concept of a ‘depressive habituality.’ This term refers to the acquisition of a new set of habitualisations, especially on the foundational levels of automatic mental life. It offers explanations for the fact that it is not easy to recover from depression and that people may more easily become depressed again. (shrink)

This article aims at grounding critical theories with the help of psy discourses. Even if the relationship between the two disciplines has always been a controversial one, the article argues that therapeutic knowledge that accesses empirical forms of social suffering may offer important insights for critical theory. This general argument is demonstrated by complementing the theories of Bourdieu and Habermas with a clinical description of depression. First, the limitations of the capabilities of these influential theories in terms of how they (...) can be used to conceptualize the variety of social suffering are introduced. Second, the psy discourses on depression are reviewed to identify and highlight latent references to the social. Third, by combining models of depressive suffering and various distortions of integration, an extended normative basis is elaborated. Instead of solely criticizing inequalities or distortions of communication, those social constellations are criticized that trap actors by producing a homogenous pattern of suffering. (shrink)

Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our (...) study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs. (shrink)

Moralising accounts of depression include the idea that depression is a sin or the result of sin, and/or that it is the result of demonic possession which has occurred because of moral or spiritual failure. Increasingly some Christian communities, understandably concerned about the debilitating effects these views have on people with depression, have adopted secular folk psychiatry’s ‘medicalising’ campaign, emphasising that depression is an illness for which, like (so-called) physical illnesses, experients should not be held responsible. This paper argues that (...) both moralising and medicalising models of depression are intellectually and practically (pastorally and therapeutically) problematic, gesturing towards more promising emphases. (shrink)

Over 50% of the world population will develop a psychiatric disorder in their lifetime.1 In the realm of psychiatric treatment, two primary modalities have been established: pharmacotherapy and psychotherapy. Yet, pharmacological interventions often take precedence as the initial treatment choice despite their comparable outcomes, severe side effects and disputed evidence of their efficacy. This preference for medication foregrounds a vital re-examination of what it means to be invasive in medical treatments, namely in psychiatric care. De Marco et al challenge the (...) standard account of invasiveness, presenting considerations that transcend the traditional criteria of physical intrusion.2 Through case studies centred on treatments for schizophrenia and depression, we aim to (1) reinforce De Marco et al ’s challenge to the standard account of invasiveness and (2) extend the dialogue to the moral imperative of redefining mental invasiveness. Our aims are to broaden the definition of mental invasiveness, aligning with De Marco et al ’s emphasis on context sensitivity, and to include the severity of side effects as a critical factor in this assessment. Redefining what is considered invasive in psychiatric treatment has profound implications for patient care and medical decision-making. Labelling treatments, namely medications, as invasive encourages both patients and healthcare providers to approach these options with a heightened level of scrutiny and care. This is …. (shrink)

High quality monitoring of mental health and well-being over an extended period is essential to understand how communities respond to the COVID-19 pandemic and how to best tailor interventions. Multiple community threats may also have cumulative impact on mental health, so examination across several contexts is important. The objective of this study is to report on changes in mental health and well-being in response to the Australian bushfires and COVID-19 pandemic. This study utilized an Experience-Sampling-Method, using the (...) smartphone-based mood monitoring application, MoodPrism. Participants were prompted once a day to complete a brief survey inquiring about symptoms of depression and anxiety, and several well-being indices, including arousal, emotional valence, self-esteem, motivation, social connectedness, meaning and purpose, and control. Participants were N = 755 Australians who downloaded and used MoodPrism, between 2018 and 2020. Results showed that anxiety symptoms significantly increased during the COVID-19 pandemic, but not during the bushfires. This may be explained by concurrent feelings of social connectedness maintained during the bushfires but not during the pandemic. In contrast, depressive symptoms increased significantly during the bushfires, which maintained during the pandemic. Most indices of well-being decreased significantly during the bushfires, and further again during the pandemic. Study findings highlight the unique responses to the bushfire and COVID-19 crises, revealing specific areas of resilience and vulnerability. Such information can help inform the development of public health interventions or individual clinical treatment, to improve treatment approaches and preparedness for potential future community disasters. (shrink)

Objectives: Initially, we analyzed relations between the challenging working conditions of flight attendants with symptoms of depression, anxiety and stress. As the COVID-19 pandemic plunged airlines into an unprecedented crisis, its impact on the mental health of flying cabin crews became the focus of a second survey.Methods: Flight attendants were surveyed online with DASS-21 in May 2019 and April 2020, complemented with questions about working conditions and existential fears and fear of job loss.Results: Sample 1 revealed that symptoms of (...) depression, anxiety and stress highly correlated with the subjective assessment of working conditions, but not with objectifiable parameters. Sample 2 showed significant positive correlations between existential fears and fear of job loss with depression, anxiety and stress. Crew members, grounded in April 2020, showed significantly higher scores in depression and stress, while still flying individuals had more clinically relevant symptoms of anxiety. Mean value comparisons between sample 1 and 2 in DASS-21 revealed a significant increase in symptoms at the time of crisis with effect sizes of d = 0.63 for depression, d = 0.26 for anxiety, and d = 0.52 for stress. The incidence of clinically relevant symptoms among the respondents increased from 8 to 23%, from 6 to 14%, and from 8 to 24%.Conclusion: The COVID-19 pandemic and associated work restrictions coincide with severe impairment of mental health of flying cabin crews, consistent with a mental health protecting function of labor. (shrink)

: Within both popular and academic literature, concerns have been expressed about the implications of antidepressant use on character development. In this paper, I identify specific versions of these worries and argue that they are misguided. I begin by arguing that the obligation to suffer if it will bring about a noble character is imagined. Legitimate concerns about character enhancement remain, but they do not count against most antidepressant use. Thus there is no moral prohibition against antidepressant use. Furthermore, some (...) of the calls for caution about antidepressant use, such as those expressed by the President's Council on Bioethics, are overstated. (shrink)

ABSTRACTPreviously depressed individuals experience disturbances in affect. Affective disturbances may be related to visual mental imagery, given that imagery-based processing of emotional stimuli causes stronger affective responses than verbal processing in experimental laboratory studies. However, the role of imagery-based processing in everyday life is unknown. This study assessed mental imagery in the daily life of previously and never depressed individuals. Higher levels of visual mental imagery was hypothesised to be associated with more affective reactivity to both negatively (...) and positively valenced mental representations.This study was the first to explore mental imagery in daily life using experience sampling methodology. Previously depressed and matched never depressed individuals participated in this study. Momentary affect and imagery-based processing were assessed using the “Imagine your mood” smartphone application. Participants recorded on average 136 momentary reports ove... (shrink)

In 1992, the Canadian Psychiatric Association launched Canada’s first national campaign against mental illness, Mental Illness Awareness Week. I stress that pharmaceutical sponsorship of the first five years of MIAW was integral to shaping the trajectory of the campaign and marks a shift in the way stigma is conceived and resisted in Canada: what was an interpersonal process based on social norms becomes refigured as “self-stigma,” or an individualized process in which lack of information, education, and self-assessment contribute (...) to an inability to consider oneself as at-risk for a disease, condition, or disorder. (shrink)

The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed (...) methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced, with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter,Smiling Mind,MoodMission,MindShift, andDestressify. Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps.Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry, which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p. (shrink)

The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalising mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis such as confirmatory factor analysis, or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting (...) data from an African sample to both CFA and latent class analysis to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum—Short Form and Patient Health Questionnaire—9 ; and LCA on combined item responses. College students from Ghana, Kenya, Mozambique, and South Africa completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF, and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms, flourishing with low endorsement of depressive symptoms, and moderate mental health with high endorsement of depressive symptoms. These findings further contribute to affirming the evidence for the dual-continua model of mental health, with implications for the assessment of mental health, to inform policy, practise, and future research in community and clinical settings in Africa. (shrink)

Since 1991, the Patient Self-Determination Act (PSDA) has required all health care institutions that receive Federal funds to inform patients upon admission of their rights to make decisions about medical care and to execute advance directives. Implementation of the PSDA presents a special challenge for state mental hospitals. The relevance and possible negative therapeutic impact of discussing end of life decisions at the time of an acute psychiatric admission has recently been raised in the literature. Other ethical dilemmas arising (...) from the interplay between mental illness and informed consent for medical treatment, particularly for older patients committed to state mental hospitals, have been highlighted by the PSDA. In this article we discuss some of the issues raised by implementation of the PSDA in this setting. (shrink)

Most mental health research largely ignores or minimises gender and age differences in depression. In ‘Don't mind the gap: Why do we not care about the gender gap in mental health?’, Patalay and Demkowicz identify a dearth of research on the causal factors of depression in young women. They attribute this to an over-reliance on biological accounts of gender differences in depression. Patalay and Demkowicz conclude that a person-centred approach that meaningfully engages with the reports of young women (...) with depression is more likely to expose the social drivers of depression that impact this group. This commentary focuses on Patalay and Demkowicz's call to examine the patient's lived experience. We argue that there is an urgent need to reflect upon the methodologies involved in examining lived experience and how they can be best utilised. Ultimately, we advocate for an approach known as ‘phenomenological psychopathology’, through a phenomenological investigation of depression in young women, we can go some way towards closing the gender gap. (shrink)

How to draw the line between depression-as-disorder and non-pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach.On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present (...) four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right. (shrink)

The present study aimed to examine the neural mechanisms underlying the ability to process the mental rotation with mirrored stimuli for different depressive tendencies with psychomotor retardation. Using functional near-infrared spectroscopy, we measured brain cortex activation of participants with higher and lower depressive tendencies while performing a left-right paradigm of object mental rotation or a same-different paradigm of subject mental rotation. Behavioral data revealed no differences in reaction time and rotation speed. The fNIRS data revealed a higher (...) deactivation of oxyhemoglobin change for the higher depression group in the perceptual stage of object mental rotation with mirrored stimuli in the superior external frontal cortex, inferior frontal gyrus, premotor cortex, and primary motor cortex. In addition, there existed a significant difference between the two groups in premotor cortex in subject mental rotation with mirrored stimuli. These results suggest that the neural mechanism of higher depression individuals connected with psychomotor retardation exists in the frontal and motor areas when processing object mental rotation with mirrored stimuli, and the motor cortex when processing subject mental rotation. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial (...) conducted across five school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

Despite the relevance of silence in several psychopathologies, first-person perspectives on silence have been largely neglected in the phenomenological scholarship on those conditions. This paper proposes a phenomenological framework for addressing this neglect and demonstrates its usefulness through a case study of empty silence, an experience which can be found in many first-person accounts of depression. The paper begins by surveying research on silence in depression in mental health research and phenomenological psychopathology. Drawing on the thought of Merleau-Ponty, it (...) then outlines a phenomenological framework for explicating the structure of silence experiences in psychopathology. Finally, it applies this framework to articulate the experiential structure and implications of empty silence, with a particular emphasis on the bodily doubt that can flow from repeated experiences of empty silence. (shrink)

In this article, I examine stigmatizing and especially patronizing attitudes towards others’ depression that people who are well-intentioned produce. The strategy of the article is to consider the social experience of depression through two separate subfields of philosophy: epistemic injustice and phenomenology. The solution that I propose is a phenomenological account of empathy. The empathetic attitude that I argue for involves actively listening to the depressed individual and taking their depression testimony as direct evidence. The article has been written both (...) for those who seek to better support neurodiverse people in their lives and for depressives (and other neurodivergents) themselves in order to provide them with a better account for advocating for themselves against social stigma. (shrink)

Psychiatric disorders can pose problems in the assessment of decision-making capacity (DMC). This is so particularly where psychopathology is seen as the extreme end of a dimension that includes normality. Depression is an example of such a psychiatric disorder. Four abilities (understanding, appreciating, reasoning and ability to express a choice) are commonly assessed when determining DMC in psychiatry and uncertainty exists about the extent to which depression impacts capacity to make treatment or research participation decisions.

Major depression is a disorder of the mind caused by dysfunction of both the body and the brain. Because it is a psychiatric illness and psychiatry is a branch of medicine, the question of how mind and body interact in depression should be treated as a medical rather than metaphysical mind-body problem. The relation between mind and body as it pertains to this illness should be construed in teleological rather than causal terms. Mental states like beliefs and emotions serve (...) an adaptive purpose by constraining the physiologic systems involved in the body's stress response, thus preserving homeostasis and protecting us from various disorders. Depression results when the mind fails it its constraining role. (shrink)

Most mental disorders affect only a small segment of the population. On the reasonable assumption that minds or brains are prone to occasional malfunction, these disorders do not seem to pose distinctive explanatory problems. Depression, however, because it is so prevalent and costly, poses a conundrum that some try to explain by characterizing it as an adaptation—a trait that exists because it performed fitness-enhancing functions in ancestral populations. Heretofore, proposed evolutionary explanations of depression did not focus on thought processes; (...) instead, they emphasized that it facilitates navigation of adverse social circumstances or promotes immune response to infectious agents. According to a new hypothesis, the “analytical rumination hypothesis” (ARH), however, depression’s crucial adaptive trait is rumination—negative, intrusive thought. ARH holds that, (i) social dilemmas trigger depressed mood; (ii) depressed mood induces changes in body systems that facilitate ruminative analysis aimed at solving dilemmas; and, (iii) depressive rumination is a fitness-enhancing trait that was selected for in evolutionary time. Jointly, (i)~(iii) imply that we should not think of rumination as a disorder; instead, it is a trade-off, an eminently rational one. In the same way that fever solves a problem—coordination of the immune system in response to infection—so too does depressive rumination solve a problem, a social dilemma, albeit at the cost of inducing anhedonia and other maladies. But they argue that the cost is worthwhile, something that should be endured “until the problem is solved.” First, we argue that there are two distinct types of rumination, brooding and pondering; the former is associated with a disposition for depression, not the latter. But only the latter has the problem-solving capabilities that ARH requires. Second, recent brain imaging studies of depression reveal resting state hypoactivity in lateral regions and hyperactivity in paralimbic regions; this asymmetric pattern correlates with heightened levels of brooding, self-focused rumination. In other words, on the personal level, patients are trapped within self, isolated from the external world and suffused with negative affect; on the subpersonal level, this pattern is reflected by an asymmetric pattern of lateral vs. paralimbic resting state activity. Third, we proceed to conjecture that rational responses (e.g., pondering) to social dilemmas are those that strike a balance between internal and external considerations in the process of belief formation. Fourth, because the asymmetric resting state activity blocks those who suffer with depression from accessing and processing potentially positive stimuli from the external world, the capacity for rational, analytic response—hence, problem-solving—is constrained. Fifth, it follows that, although there might be conditions for which suffering should be endured rather than pharmacologically alleviated, depression is not one of those. Indeed, in view of the effects of the asymmetric resting state pattern, it is unlikely that depressive rumination would have been useful even for ancestral populations. (shrink)

This paper describes a discourse analysis of the process of interpersonal psychotherapy (IPT) in the recovery from depression. It demonstrates how IPT is an effective treatment strategy for mental health nurses to utilise in the treatment of depression. The discourse analysis highlights how the development of more meaningful subject positions enables one woman to recover from her depression. The process of recovery is underpinned by an understanding of women's depression as promoted by contemporary social and cultural expectations for detachment (...) and reflexivity. This paper shows how IPT provides an opportunity for recovery from depression for one woman by facilitating a reconstruction of her subject positions in relation to others. The discourse analysis revealed that the therapist facilitated this through the use of a range of techniques: seeking information, exploring beliefs/values/assumptions, exploring communication patterns, exploring affective responses and exploring alternative subject positions. (shrink)

The subject of this paper is the problematisation of depression in today’s mental health care. It is based on a study of the professional discussion on depression in Finland from the mid-1980s to the 1990s. The ways in which Finnish mental health experts define the object of depression treatment bring out an ambivalence that stems from the discrepancy between two parallel but incongruent notions of what depression is: the psychopharmacological and the psychotherapeutic. The analysis of the discussion demonstrates (...) how clinical and practical rationales of today’s mental health care are formed in the space between the two poles. Two tendencies of these rationales are also pointed out: first, the DSM paradigm of depressive illness inclines to become problematic and to dissolve in the actual practices. Second, they insinuate emphasis on antidepressant medication and overall neuropsychiatric approach in the treatment of depressive disorders, although in an ambivalent way. (shrink)

Depression is vastly heterogeneous in its symptoms, neuroimaging data, and treatment responses. As such, describing how it develops at the network level has been notoriously difficult. In an attempt to overcome this issue, a theoretical “negative prediction mechanism” is proposed. Here, eight key brain regions are connected in a transient, state-dependent, core network of pathological communication that could facilitate the development of depressive cognition. In the context of predictive processing, it is suggested that this mechanism is activated as a response (...) to negative/adverse stimuli in the external and/or internal environment that exceed a vulnerable individual’s capacity for cognitive appraisal. Specifically, repeated activation across this network is proposed to update an individual’s brain so that it increasingly predicts and reinforces negative experiences over time—pushing an individual at-risk for or suffering from depression deeper into mental illness. Within this, the negative prediction mechanism is poised to explain various aspects of prognostic outcome, describing how depression might ebb and flow over multiple timescales in a dynamically changing, complex environment. (shrink)

Laacke et al. describe the emergence of novel analytical tools—artificial intelligence depression detectors —that employ artificial intelligence to predict depression. The authors the...

The approach to mental health and well‐being taken here illustrates the complementary perspectives approach and assumes that there are useful and intersecting contributions from science (including medicine) and from religion and spirituality. What counts as poor mental well‐being depends on the interaction of relatively objective criteria with culturally contingent value judgments. I then discuss theological perspectives on depression, including a consideration of sources of hope and tolerance of dysphoria, and argue that depression can be part of a spiritual (...) journey. I then look at the relationship between psychosis and religion, including the work of Isabel Clarke, arguing that a spiritual approach to psychosis can complement a medical approach. Finally, I present a pastoral case study illustrating the interface between neurological and spiritual aspects of the sense of presence. A religious perspective can challenge and complement current assumptions about mental health in a potentially fruitful way. (shrink)

In this paper, I address the question of whether it is ever permissible to grant a request for physician-aid-in-dying (PAD) from an individual suffering from treatment-resistant depression. I assume for the sake of argument that PAD is sometimes permissible. There are three requirements for PAD: suffering, prognosis, and competence. First, an individual must be suffering from an illness or injury which is sufficient to cause serious, ongoing hardship. Second, one must have exhausted effective treatment options, and one’s prospects for recovery (...) must be poor. Third, the individual must be judged competent to request PAD. I argue that many cases of treatment-resistant depression meet the first two requirements. Thus, the key question concerns the third. I consider four features of depression that might compromise a person’s decision-making capacity. Ultimately, I conclude that PAD requests from depressed patients can be permissibly granted in some circumstances. (shrink)

In this paper, I offer an argument for cultivating cheerfulness as a remedy to sadness and other emotions, which, in turn, can provide some relief to certain cases of depression. My thesis has two tasks: first, to establish the link between cheerfulness and sadness, and second, to establish the link between sadness and depression. In the course of accomplishing the first task, I show that a remedy of cultivating cheerfulness to counter sadness is supported by philosophers as diverse as Thomas (...) Aquinas, Baruch Spinoza, and David Hume in their writings on the passions. I also show that my argument can generalize to promote the cultivation of other emotions. In the course of accomplishing the second task, I consider different models of depression and how the emotions are related to depression. The purpose of this paper is to offer conceptual, philosophical support that is consistent with the most current empirical data on depression. (shrink)

Background: Depression is the largest cause of mental ill health worldwide. Although interventions such as Dance Movement Therapy (DMT) may offer interesting and acceptable treatment options, current clinical guidelines do not include these interventions in their recommendations mainly because of what is perceived as insufficient research evidence. The 2015 Cochrane review on DMT for depression includes only three RCTs leading to inconclusive results. It is therefore, necessary to also look beyond such designs in order to identify and assess the (...) range of current evidence. Methods: We therefore, conducted a systematic review of studies that aimed to explore the effectiveness in the use of DMT with people with depression. This led to a qualitative narrative synthesis followed by a subgroup analysis and a sensitivity analysis. In all meta-analyses a random effects model was used with Standardised Mean Differences (SMD) to accommodate for the heterogeneity of studies and outcome measures. Results: From the 817 studies reviewed, eight studies met our inclusion criteria. 351 people with depression (mild to severe) participated, 192 of whom attended DMT groups while receiving treatment as usual (TAU) and 159 received TAU only. Qualitative findings suggest there was a decrease in depression scores in favour of DMT groups in all studies. Subgroup analysis performed on depression scores before and three months after the completion of DMT groups suggested changes in favour of the DMT groups. When sensitivity analysis was performed, RCTs at high risk of bias were excluded, leaving only studies with adult clients up to the age of 65. In these studies, the highest effect size was found favouring DMT plus TAU for adults with depression, when compared to TAU only. Conclusions: Based on studies with moderate to high quality, we concluded that DMT is an effective intervention in the treatment of depression with adults. Furthermore, by drawing on a wide range of designs with diverse quality, we were able to compile a comprehensive picture of relevant trends. Despite the fact that there remains a paucity of high-quality studies, the results have relevance to both policy-making and clinical practice, and become a platform for further research. (shrink)

IntroductionGratitude is commonly known as a positive emotion, but it can also be understood as a disposition—one’s inherent quality that includes being grateful for the positive aspects of one’s life and appreciating altruistic gifts. A growing body of research suggests that having a disposition of gratitude is positively related to wellbeing and psychological adjustment. The present study examined the extent to which acceptance of illness—a measure of adjustment to a distressing condition—mediated relationships between dispositional gratitude and wellbeing among women who (...) had elevated levels of depressive symptoms.MethodsParticipants were 131 women who, based on scores on the Center for Epidemiological Studies Depression scale, were at-risk for experiencing clinical depression. Thirty-five of these participants had been diagnosed as depressed at some point in their lives and 96 had not. Participants completed measures of dispositional gratitude, wellbeing, anxiety, and acceptance of illness.ResultsDispositional gratitude was positively correlated with wellbeing and was negatively correlated with depression and anxiety. Dispositional gratitude was also positively correlated with acceptance of illness. Mediational analyses found that acceptance of illness mediated relationships between dispositional gratitude and wellbeing, between dispositional gratitude and anxiety, and between dispositional gratitude and depression. Moreover, such mediation varied as a function of whether women had ever been diagnosed as depressed. Acceptance of illness was related more strongly to wellbeing for women who had been diagnosed as depressed at some time in their lives than it was for women who had never been diagnosed as depressed.ConclusionWomen with elevated depressive symptoms who were more grateful were more accepting of their condition, which was related to increased wellbeing and decreased feelings of depression and anxiety. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, emphasizes diagnosis and statistically significant commonalities in mental disorders. As stated in the Introduction, “[i]t must be admitted that no definition adequately specifies precise boundaries for the concept of ‘mental disorder’ ” (DSM-IV, 1994, xxi). Further, “[t]he clinician using DSM-IV should ... consider that individuals sharing a diagnosis are likely to be heterogeneous, even in regard to the defining features of the diagnosis, and that boundary cases will (...) be difficult to diagnose in any but a probabilistic fashion” (DSM-IV, 1994, xxii). This article proposes that it may be helpful for clinicians to study narratives of illness which emphasize this heterogeneity over statistically significant symptoms.This paper examines the recorded experiences of unusually articulate sufferers of the disorder classified as Major Depression. Although sharing a diagnosis, Hemingway, Fitzgerald, and Styron demonstrated different understandings of their illness and its symptoms and experienced different resolutions, which may have had something to do with the differing meanings they made of it.I have proposed a word, autopathography, to describe a type of literature in which the author's illness is the primary lens through which the narrative is filtered. This word is an augmentation of an existing word, pathography, which The Oxford English Dictionary, Second Edition, defines as “a) [t]he, or a, description of a disease,” and “b) [t]he, or a, study of the life and character of an individual or community as influenced by a disease.” The second definition is the one that I find relevant and which I feel may be helpful to clinicians in broadening their understanding of the patient's experience. (shrink)

Studies on mental health and academic performance have been conducted throughout the world. Thus, this study aims to assess the students' mental health amidst the new normal of education employing 21-item Depression, Anxiety, and Stress Scale or DASS-21, concerning their academic performance. The study's findings showed that almost more than half of the respondents suffered from moderate to extremely severe levels of depression, stress, and anxiety. Thus, there was no significant relationship between high negative mental health symptoms (...) and academic performance. In conclusion, students that encounter extreme levels of adverse mental health can still maintain high academic achievement. However, the students' mental health should always be managed and helped to cope with their life problems, especially during this pandemic crisis. (shrink)

Reflexivity and detachment: a discursive approach to women's depression This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the (...) focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse. (shrink)

During the last decade, children have shown an increasing need for mental wellbeing interventions due to their anxiety and depression issues, which the COVID-19 pandemic has exacerbated. Socially Assistive Robotics have been shown to have a great potential to support children with mental wellbeing-related issues. However, understanding how robots can be used to aid the measurement of these issues is still an open challenge. This paper presents a narrative review of child-robot interaction (cHRI) papers (IEEE ROMAN proceedings from (...) 2016–2021 and keyword-based article search using Google Scholar) to investigate the open challenges and potential knowledge gaps in the evaluation of mental wellbeing or the assessment of factors affecting mental wellbeing in children. We exploited the SPIDER framework to search for the key elements for the inclusion of relevant studies. Findings from this work (10 screened papers in total) investigate the challenges in cHRI studies about mental wellbeing by categorising the current research in terms of robot-related factors (robot autonomy and type of robot), protocol-related factors (experiment purpose, tasks, participants and user sensing) and data related factors (analysis and findings). The main contribution of this work is to highlight the potential opportunities for cHRI researchers to carry out measurements concerning children’s mental wellbeing. (shrink)

The comorbidity of personality disorders and mental disorders is commonly understood through three types of theoretical models: either a) personality disorders precede mental disorders, b) mental disorders precede personality disorders, c) mental disorders and personality disorders share common etiological grounds. Although these hypotheses differ with respect to their idea of causal direction, they all imply a latent variable perspective, in which it is assumed that either personality and mental disorders are latent variables that have certain (...) causal relations [models a) and b)]; or that, as in model c), the common etiology is in fact a latent variable that causes symptomatology of both personality and mental disorders. We aim to provide another perspective on the comorbidity between personality and mental disorders, namely a network perspective. To this end, we investigated Major Depression and Borderline Personality Disorder and hypothesized that symptoms of BPD and MD could interact with one another rather than being caused by a latent variable. To illustrate this theoretical network conceptualization of the comorbidity of BPD and MD we analyzed a cross-sectional clinical dataset of 376 patients who were asked to complete the Structured Clinical Interview for DSM-IV Axis II Disorders and the Beck Depression Inventory II. The results identify direct associations between symptoms of MD and BPD. If we take the links in this empirical network to be ‘substantive', this suggests a radical shift of our current conceptualization of the comorbidity of mental disorders and personality disorders. (shrink)

Background: Prenatal and postnatal mental disorders can exert severe adverse influences on mothers, fetuses, and children. However, the effect of the coronavirus disease 2019 pandemic on the mental health of pregnant and postpartum women remains unclear.Methods: Relevant studies that were published from January 1, 2019 to September 19, 2020 were identified through the systematic search of the PubMed, EMBASE, and Web of Science databases. Quality assessment of included studies, random-effects meta-analysis, sensitivity analysis, and planned subgroup analysis were performed.Results: (...) A total of 23 studies conducted with 20,569 participants during the COVID-19 pandemic and with 3,677 pregnant women before the COVID-19 pandemic were included. The prevalence rates of anxiety, depression, psychological distress, and insomnia among pregnant women during the COVID-19 pandemic were 37%, 31%, 70%, and 49%, respectively. The prevalence of postpartum depression was 22%. Multigravida women and women in the first and third trimesters of pregnancy were more vulnerable than other pregnant women. The assessment of the associations between the COVID-19 pandemic and mental health problems revealed that the pooled relative risks of anxiety and depression in pregnant women were 1.65 and 1.08, respectively.Conclusions: The prevalence rates of mental disorders among pregnant and postpartum women during the COVID-19 pandemic were high. Timely and tailored interventions should be applied to mitigate mental problems among this population of women, especially multigravida women and women in the first and third trimesters of pregnancy. (shrink)

Depression is the principal cause of illness and disability in the world. Studies charting the prevalence of depression among children and adolescents report high percentages of youngsters in both groups with depressive symptoms. This review analyzes the construct and explanatory theories of depression and offers a succinct overview of the main evaluation instruments used to measure this disorder in children and adolescents, as well as the prevention programs developed for the school environment and the different types of clinical treatment provided. (...) The analysis reveals that in mental classifications, the child depression construct is no different from the adult one, and that multiple explanatory theories must be taken into account in order to arrive at a full understanding of depression. Consequently, both treatment and prevention should also be multifactorial in nature. Although universal programs may be more appropriate due to their broad scope of application, the results are inconclusive and fail to demonstrate any solid long-term efficacy. In conclusion, we can state that: (1) There are biological factors (such as tryptophan—a building block for serotonin-depletion, for example) which strongly influence the appearance of depressive disorders; (2) Currently, negative interpersonal relations and relations with one's environment, coupled with social-cultural changes, may explain the increase observed in the prevalence of depression; (3) Many instruments can be used to evaluate depression, but it is necessary to continue to adapt tests for diagnosing the condition at an early age; (4) Prevention programs should be developed for and implemented at an early age; and (5) The majority of treatments are becoming increasingly rigorous and effective. Given that initial manifestations of depression may occur from a very early age, further and more in-depth research is required into the biological, psychological and social factors that, in an interrelated manner, may explain the appearance, development and treatment of depression. (shrink)

Christian interpretations of what psychiatry terms "depression" vary widely. Although liberal forms of Christianity regard depression as both a form of mental illness and a catalyst for moral and spiritual transformation, some Catholic theology regards some forms depression not as pathological but as a Dark Night of the Soul. Nonliberal Protestant forms of Christianity tend to view depression more as a sign of spiritual illness than spiritual health: an indication of demonic possession in some Charismatic and syncretistic/indigenous forms of (...) Christianity, and a sin or a result of sin, primarily in conservative Evangelical thought.This paper is about the... (shrink)