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O'Sullivan H, Goodwin J, O'Malley M, Happell B, O'Donovan A. "The third wing of the plane": Fathers' perceptions of their role in the treatment process for daughters with eating disorders. Int J Ment Health Nurs 2024; 33:992-1002. [PMID: 38297968 DOI: 10.1111/inm.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 02/02/2024]
Abstract
Eating disorders are complex mental health conditions exacerbated by high mortality rates. International and national guidelines recommend family involvement in the treatment process, recognising the family as an important source of support to young people. Research suggests fathers engage less in the process compared to mothers. In studies exploring parental perspectives, most samples consisted of mothers, with fathers minimally represented. Few studies explore family involvement from the perspective of fathers. This study aimed to explore the experiences of fathers regarding their involvement in the treatment process. Qualitative descriptive methods were used, involving focus group interviews of seven fathers. Interviews were assisted by a semi-structured interview guide. A qualitative content analysis approach was used to analyse the data regarding paternal experiences of engagement in the treatment process. Fathers understood the importance of the whole family working together but viewed mothers as taking a more central role in the treatment process, with fathers more at the periphery. Gender emerged as an influencing factor in paternal involvement, with mothers primarily taking on responsibility for the child with the eating disorder and fathers providing secondary support. Healthcare providers need to be aware of the contribution of gendered roles within the family system and consider this when working with families within the treatment process. Consequently, mental health nurses have an important role in encouraging fathers to become actively involved in the treatment process.
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Affiliation(s)
- Hazel O'Sullivan
- School of Nursing and Midwifery, University College Cork, County Cork, Ireland
- Health Services Executive, County Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, University College Cork, County Cork, Ireland
| | - Maria O'Malley
- School of Nursing and Midwifery, University College Cork, County Cork, Ireland
| | - Brenda Happell
- School of Nursing and Midwifery, University College Cork, County Cork, Ireland
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, University College Cork, County Cork, Ireland
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2
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Koo FEC, Chan MCE, King SK, Trajanovska M. The early years: hirschsprung disease and health-related quality of life. Qual Life Res 2023; 32:3327-3337. [PMID: 37474849 DOI: 10.1007/s11136-023-03482-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Chronic diseases are notorious in the way that they interfere with many aspects of a child's development, and this holds true for children with Hirschsprung disease (HD). The present research aims to (1) determine whether the health-related quality of life (HRQoL) of HD children differs from healthy paediatric populations; and (2) explore the relationship between HD children's HRQoL and psychosocial outcomes of parents. METHODS Using a cross-sectional survey study design, children's HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL), while parental psychosocial outcomes were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression short-forms, Family Management Measure (FaMM), and Parent Experience of Child Illness. Surveys were administered over telephone to parents of 48 Australian children treated for HD (87.5% male, median age 4.5 years) during the period May to November 2021. RESULTS While postoperative HRQoL of HD children was comparable to that of healthy age-matched controls, psychosocial quality of life of HD children was significantly poorer (mean difference = 3.40, CI [0.05, 6.76]). All parental outcome measures were significantly correlated with the PedsQL (r = - 0.77-0.67, p < 0.05) in expected directions, with FaMM subscales (except parent mutuality) demonstrating the most variation (R2 = 0.41-0.59). Of note, 31.3% of parents reported moderate to severe symptoms of anxiety on the PROMIS. CONCLUSION Despite overall positive results for children, parents reported elevated symptoms of anxiety. This study highlights the importance of long-term follow-up care for HD patients and their families.
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Affiliation(s)
- Fern Ee Caryn Koo
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC, Australia
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia
| | - Man Ching Esther Chan
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC, Australia
| | - Sebastian K King
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Department of Paediatric Surgery, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Misel Trajanovska
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia.
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
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Migliorini C, Barrington N, O'Hanlon B, O'Loughlin G, Harvey C. The Help-Seeking Experiences of Family and Friends Who Support Young People With Mental Health Issues: A Qualitative Study. QUALITATIVE HEALTH RESEARCH 2023; 33:191-203. [PMID: 36650446 DOI: 10.1177/10497323221147130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Little has been documented of the journey that family and friends (F&F) undertake when supporting a young person aged 12-25 years struggling with mental illness. The experiences of family and friends were explored using an online qualitative survey (N = 58) and semi-structured interviews (n = 15). Recruitment was through a national youth mental health service Facebook page and website. An experiential thematic analysis was conducted focusing on participants' experiences and sense of their world.Strong feelings and challenging life circumstances made the context of help-seeking complicated. Despite following usual avenues for advice or support, F&F still came across professionals and a health/mental health system that compounded their distress. It was the simpler things that some professionals did that made their journey more bearable. Useful insights derived from the narratives allow service improvement recommendations such as reminding professionals of the multiplicity of stressors commonplace to families and the value of validation and acknowledgement.
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Affiliation(s)
- Christine Migliorini
- The Psychosocial Research Centre, Department of Psychiatry, 85084The University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas Barrington
- 67427The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Brunswick, Victoria, Australia
| | - Brendan O'Hanlon
- 67427The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Brunswick, Victoria, Australia
| | | | - Carol Harvey
- The Psychosocial Research Centre, Department of Psychiatry, 85084The University of Melbourne, Parkville, Victoria, Australia
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Migliorini C, Lam DSM, Harvey C. Supporting family and friends of young people with mental health issues using online technology: A rapid scoping literature review. Early Interv Psychiatry 2022; 16:935-957. [PMID: 34729912 DOI: 10.1111/eip.13230] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 10/19/2021] [Indexed: 12/25/2022]
Abstract
AIM Family and friends are often the first and/or only support options used by young people (12-25 years) struggling with mental health issues. The overarching aim of this literature review is to map current practice in online interventions specifically targeting family and friends of young people with mental health issues, especially relevant in light of the current worldwide COVID-19 pandemic. METHODS A rapid scoping literature review was conducted searching health and psychology databases for online interventions targeting family and friends supporting a young person (12-25 years) struggling with a mental health issue. The search strategy was comprehensive and expert librarian endorsed. The final synthesis comprised 13 articles. RESULTS Identified articles were few, reporting a disparate range of research aims, intervention content and delivery modes. Studies addressing caregivers of adolescents with a mental health diagnosis were small-scale, although suggested virtual modalities are positively received and viable alternatives to other delivery methods with potential for equivalent outcomes. Five randomized control trials involving caregivers of 'at-risk' adolescents reported improved parental knowledge, but mixed effects on family functioning. CONCLUSIONS Preliminary evidence suggests flexible online options including professional and peer support, to respond to carers' busy lives are needed to maximize benefits. Content that is sufficiently individualized and targeted to address the diverse needs of parents, as well as other caregivers, is also required. Well-being and self-care, in addition to parenting skills should be given more consideration in online interventions. Examination of the value of support from peers is also warranted.
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Affiliation(s)
- Christine Migliorini
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Carol Harvey
- Psychosocial Research Centre, NorthWestern Mental Health Service, Coburg, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
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Vilaregut A, Roca M, Ferrer M, Pretel-Luque T, Calvo N. Exploring the psychological impact of COVID-19 on adolescents with borderline personality disorder and their mothers: A focus group study. Clin Child Psychol Psychiatry 2022; 27:157-176. [PMID: 34875884 PMCID: PMC8814617 DOI: 10.1177/13591045211058318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to explore the impact of the coronavirus pandemic on adolescents diagnosed with Borderline Personality Disorder (BPD) and their mothers. This exploratory study used a qualitative focus group approach. This study's sample group consisted in nine participants: five adolescents diagnosed with BPD and their four mothers. Patients were recruited from a specialized BPD outpatient unit of a university hospital psychiatry department. The results are divided into two main areas, the first regarding the lockdown period and the second examining the period of gradual relaxation of lockdown restrictions. The results show that the adolescents had difficulties in the management of their interpersonal relationships, especially in striking a balance between individual and family space, as well as in communication, cohesion, and family dynamics. During the COVID lockdown, adolescents experienced a stabilization of psychopathological symptoms, but these symptoms worsened when the lockdown restrictions were lifted. Nevertheless, they reported having learned and implemented self-care strategies. The findings are discussed in terms of both individual and family impact, shedding light on some of the challenges precipitated by the COVID-19 pandemic.
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Affiliation(s)
- Anna Vilaregut
- FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Mariona Roca
- FPCEE Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Marc Ferrer
- Psychiatry Department, Vall d’Hebron University Hospital, Mental Health Network Biomedical Research Center (CIBERSAM), Barcelona, Spain
- Psychiatry, Mental Health and Addictions Group, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Grup TLP Barcelona, Barcelona, Spain
| | | | - Natàlia Calvo
- Psychiatry Department, Vall d’Hebron University Hospital, Mental Health Network Biomedical Research Center (CIBERSAM), Barcelona, Spain
- Psychiatry, Mental Health and Addictions Group, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Grup TLP Barcelona, Barcelona, Spain
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Sheng Q, Cai C, Li P, Chen L, Zhang X, Wang X, Gong Y. Development and Validation of a Nomogram for Predicting the Unresolved Risk of Parents of Adolescents With Psychiatric Diagnoses. Front Psychiatry 2022; 13:796384. [PMID: 35432017 PMCID: PMC9010732 DOI: 10.3389/fpsyt.2022.796384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/01/2022] [Indexed: 12/29/2022] Open
Abstract
Evaluating the resolution of parents of ill children can help in taking measures to alleviate their distress in a timely manner and promote children's rehabilitation. This study aims to develop and validate a nomogram for predicting the unresolved risk of parents of adolescents with psychiatric diagnoses. The data for 130 parents (modeling dataset = 90; validation dataset = 40) were collected. A nomogram was first developed to predict the unresolved risk for parents based on the logistic regression analysis in the modeling dataset. The internal and external validation then were conducted through quantifying the performance of the nomogram with respect to discrimination and calibration, respectively, in the modeling and validation datasets. Finally, the clinical use was evaluated through decision curve analyses (DCA) in the overall dataset. In the results, the nomogram consisted of six risk factors and provided a good discrimination with areas under the curve of 0.920 (95% CI, 0.862-0.978) in internal validation and 0.886 (95% CI, 0.786-0.986) in external validation. The calibration with good consistency between the observed probability and predicted probability was also found in both internal and external validation. DCA showed that the nomogram had a good clinical utility. In conclusion, the proposed nomogram exhibited a favorable performance with regard to its predictive accuracy, discrimination capability, and clinical utility, and, thus, can be used as a convenient and reliable tool for predicting the unresolved risk of parents of children with psychiatric diagnoses.
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Affiliation(s)
- Qingqing Sheng
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunfeng Cai
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Pingdong Li
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lihua Chen
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xi Zhang
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Xinyu Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yucui Gong
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Bratt AS, Rusner M, Svensson I. An exploration of group-based compassion-focused therapy for adolescents and their parents. Scand J Child Adolesc Psychiatr Psychol 2021; 8:38-47. [PMID: 33520777 PMCID: PMC7685492 DOI: 10.21307/sjcapp-2020-005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background The long-term negative consequences of mental health problems during adolescence highlight the need for effective treatments. Compassion-focused therapy (CFT) aims to help individuals to enhance their ability to support and care for themselves and to alleviate shame and self-stigmatization. Objective This non-randomized controlled trial examined the effectiveness of group-based CFT on perceived stress and the extent of self-compassion in a clinical sample of adolescents receiving psychiatric care for complex mental health difficulties and their parents. Method The participants were 43 adolescents (ages 14-17; 83.7 % female) under treatment at a child and adolescent psychiatric outpatient clinic in Sweden and their parents (n = 77; 61 % female). The adolescents volunteered for group-based CFT (n = 19); if they did not want to participate, they were asked to join the control group receiving treatment as usual (TAU, n = 24). The CFT parents were given the same treatment as their children in parallel parent groups. The participants completed questionnaires measuring self-compassion and perceived stress before and after treatment. Paired samples t-tests and independent samples t-tests assessed the within-group and between-group differences via change scores. Results The fathers scored highest on self-compassion and had less perceived stress at both times than the adolescents or mothers. There were no significant differences between the CFT and TAU groups in self-compassion or perceived stress at either time, and the effect sizes were small (g ≤ 0.25). The TAU mother group was the only group with a significantly changed mean self-compassion score post-treatment. Conclusions Some patients seem to benefit from group-based CFT in ways similar to the benefits of specialized therapeutic approaches. Further research into the utility of CFT for adolescents with MH problems and their parents, as well as the long-term clinical effects of CFT for this group is needed.
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Affiliation(s)
- Anna Sofia Bratt
- Linnaeus University, Faculty of Health and Life Sciences, Växjö, Kronoberg, Sweden
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenbrg, Sweden.,Region Västra Götaland, Södra Ävlsborg Hospital, Dep. of Research, Borås, Sweden
| | - Idor Svensson
- Linnaeus University, Faculty of Health and Life Sciences, Växjö, Kronoberg, Sweden
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Sheng Q, Zhang X, Cai C, Shi Y. Parents' Experiences of Caring for Their Only Child With Mental Illness in China: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2020; 59:29-37. [PMID: 33095263 DOI: 10.3928/02793695-20201001-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
The current study explored Chinese parents' experiences of caring for their only child with mental illness. Face-to-face interviews with semi-structured questions were conducted to learn about the care experiences of parents whose only child had mental illness. Purposeful sampling was used to recruit parents (n = 14) and thematic analysis was used. Five themes were identified: (1) Having Responsibility to Care for Children, (2) Feeling Guilt and Self-Blame, (3) Experiencing Loneliness and Helplessness, (4) Drained by Caregiving, and (5) Worrying About the Future. Parents who cared for their only child with mental illness experienced considerable emotional and physical challenges. Professionals and health care providers should recognize and understand the experiences of these parents to identity their needs and provide adequate support. Targeted support services and appropriate professional information should be developed and provided for parents to relieve them of negative caregiving experiences and improve their psychological and physical well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 29-37.].
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Bratt AS, Svensson I, Rusner M. Finding confidence and inner trust as a parent: experiences of group-based compassion-focused therapy for the parents of adolescents with mental health problems. Int J Qual Stud Health Well-being 2019; 14:1684166. [PMID: 31662062 PMCID: PMC6830276 DOI: 10.1080/17482631.2019.1684166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Purpose: Compassion-focused therapy (CFT) can alleviate the stress and challenges faced by the parents of adolescents with mental health (MH) problems. Although CFT interventions have shown promising results, few studies have examined its effectiveness in adolescent psychiatric settings. Therefore, this study examined the participant experiences of group-based CFT for the parents of adolescents with MH problems.Methods: The reflective lifeworld research (RLR) approach was used to conduct in-depth interviews with eleven parents, focusing on participant experiences of group-based CFT. Meaning-oriented data analysis was undertaken.Results: The essential meaning of the phenomenon of participating in group-based CFT was understood as finding confidence and inner trust as a parent, characterized by an understanding of one's own needs, which provided parents with the confidence to support their children. The phenomenon is further explicated with its three constituents: (a) taking care of oneself and one's child; (b) being open and sharing experiences; and (c) acceptance and hope for the future.Conclusions: The CFT intervention enabled parents to find their agency and strengthened their relationships with their children. The findings underscore the need to acknowledge the supportive role parents play in the recovery of children who receive psychiatric care.
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Affiliation(s)
- Anna Sofia Bratt
- Faculty of Health and Life Sciences, Department of Psychology, Linnaeus University, Växjö, Sweden.,Child & Adolescent Psychiatric Clinic, Södra Älvsborg Hospital, Region Västra Götaland, Borås, Sweden
| | - Idor Svensson
- Faculty of Health and Life Sciences, Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
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Ngwane VE, van der Wath AE. The psychosocial needs of parents of adolescents who attempt suicide. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1647494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Vangi E. Ngwane
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Anna E. van der Wath
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Bernaras E, Jaureguizar J, Garaigordobil M. Child and Adolescent Depression: A Review of Theories, Evaluation Instruments, Prevention Programs, and Treatments. Front Psychol 2019; 10:543. [PMID: 30949092 PMCID: PMC6435492 DOI: 10.3389/fpsyg.2019.00543] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 02/25/2019] [Indexed: 02/05/2023] Open
Abstract
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.
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Affiliation(s)
- Elena Bernaras
- Developmental and Educational Department, University of the Basque Country, Donostia/San Sebastián, Spain
| | - Joana Jaureguizar
- Developmental and Educational Psychology Department, University of the Basque Country, Lejona, Spain
| | - Maite Garaigordobil
- Personality, Evaluation and Psychological Treatments Department, University of the Basque Country, Donostia/San Sebastián, Spain
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