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Shu W, Ma X, Zhao X. Changes in Patient Discourse: A Qualitative Study Based on the Treatment Experience of Chinese Patients with Somatization Symptoms. Healthcare (Basel) 2023; 11:2811. [PMID: 37957956 PMCID: PMC10648739 DOI: 10.3390/healthcare11212811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
This qualitative study examines the characteristics exhibited by Chinese patients with somatization symptoms during their treatment process, focusing on changes in illness interpretation and language use. A semi-structured in-depth interview was conducted with 10 patients receiving treatment in a clinical psychology department of a general hospital who reported somatic symptoms as their main complaint. The interview data were recorded and transcribed, and analyzed using interpretive phenomenological analysis. Two core themes emerged from the analysis: avoidance at the utterance level; and at the semantic level, power and contestation. Patients with somatization symptoms exhibit avoidance behaviors, and their experience of illness and the therapeutic process impact their discourse. Professionals should pay attention to patients' own interpretations, cultural background and acceptance of the illness.
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Affiliation(s)
- Wenting Shu
- School of Humanities, Tongji University, Shanghai 200092, China;
| | - Xiquan Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
- Department of Psychosomatic Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China
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Krumm S, Krieg G, Lamp N, Marek F, Nickel P, Panzirsch M, Stiawa M, Beschoner P, Brieger P, Frasch K, Gertzen M, Gündel H, Hasan A, Jäger M, Kling-Lourenco P, Koussemou JM, Steber R, Kilian R. The transformation of masculinity orientations and work-related attitudes in men treated for depression (TRANSMODE): study protocol for a mixed-methods observational study. BMC Psychiatry 2023; 23:492. [PMID: 37430236 DOI: 10.1186/s12888-023-04979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Masculinity norms play a crucial role in men's help-seeking behaviors, service-use, and coping strategies for depression. While previous studies provided evidence for the association between gender role orientations, work related attitudes, stigmatization of men with depression and depressive symptoms, it remains unclear to what extent gender role orientations change over time and whether psychiatric and psychotherapeutic treatment have an impact on these transformations. Additionally, the role of partners in supporting depressed men and the impact of dyadic coping on these processes have not been explored. The aim of this study is to investigate how masculinity orientations and work-related attitudes change over time in men treated for depression, and to examine the role of their partners and dyadic coping in these transformation processes. METHODS TRANSMODE is a prospective longitudinal mixed-methods study investigating the transformation of masculinity orientations and work-related attitudes in men treated for depression between the ages of 18 and 65 from different settings in Germany. The study will recruit 350 men from various settings for quantitative analysis. By applying a latent transition analysis, the primary outcome are changes in masculine orientations and work-related attitudes over time, measured at four times (t0, t1, t2, t3) with intervals of 6 months. Qualitative interview with a subsample of depressed men selected using latent profile analysis, will be conducted between t0 and t1 (a1) with a follow-up of 12 months (a2). In addition, qualitative interviews with the partners of depressed men will be conducted between t2 and t3 (p1). Qualitative data will be analysed using qualitative structured content analysis. DISCUSSION A comprehensive understanding of the transformation processes of masculinity orientations over time including the impact of psychiatric/psychotherapeutic treatment and the role of partners can lead to the development of gender-sensitive depression treatment tailored to the unique needs of men with depression. Thus, the study can promote more effective and successful treatment outcomes and further contribute to reducing the stigma surrounding mental health issues among men and encourage them for mental health service use. TRIAL REGISTRATION This study is registered in the German Clinical Trail Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00031065 (Date of registration 06 February 2023).
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Affiliation(s)
- Silvia Krumm
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany.
| | - Gironimo Krieg
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Natalie Lamp
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Franziska Marek
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Paul Nickel
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Maria Panzirsch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Donauwörth, Donauwörth, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Christophsbad Clinic, Göppingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | | | - Karel Frasch
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Donauwörth, Donauwörth, Germany
| | - Marcus Gertzen
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Alkomiet Hasan
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | | | - José Marie Koussemou
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Heidenheim Clinic, Heidenheim, Germany
| | | | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
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Staiger T, Stiawa M, Mueller-Stierlin AS, Kilian R, Beschoner P, Gündel H, Becker T, Frasch K, Panzirsch M, Schmauß M, Krumm S. Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study. Front Psychiatry 2020; 11:599039. [PMID: 33329149 PMCID: PMC7732518 DOI: 10.3389/fpsyt.2020.599039] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/29/2020] [Indexed: 01/12/2023] Open
Abstract
Background: Many studies indicate that men are more reluctant to seek help for mental health problems than women. Traditional ideas of masculinity are often seen as a cause of this phenomenon. However, little is known about the diversity of experiences during the processes of help-seeking and service use among men with depression who have already utilized mental health services. This study aims to explore men's experiences and attitudes toward depression, help-seeking, and service use in order to develop gender-sensitive services. Methods: Narrative-biographical interviews were conducted with men treated for depression (n = 12). Interview topics included individual experience with depression, help-seeking behavior, and mental health service use. Transcripts were analyzed using qualitative content analysis. Results: Before seeking treatment, men's help-seeking behavior was negatively affected by internalized masculine norms. However, findings indicate a change of attitudes toward depression after mental health service use. Men with depression emphasized a salutogenic perspective toward mental health problems and critically reflected on masculine norms. The positive function of men-only groups were described as key for successful service use. Conclusions: Men with depression reported experiences toward help-seeking and service use on four different levels: (i) attitudes toward depression, (ii) perception of societal views on depression, (iii) experiences within the family context and (iv) experiences with mental health services. Interventions to reduce the stigma of being "unmanly" and to improve men's capacity to cope with being unable to work should be developed. Peer-led men-only groups may increase participants' self-esteem and assist in disclosing weaknesses. In the context of GPs' mediating role, training for health professionals concerning the impact of masculine norms on mental health is recommended.
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Affiliation(s)
- Tobias Staiger
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany
| | - Maja Stiawa
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany
| | | | - Reinhold Kilian
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Thomas Becker
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany
| | - Karel Frasch
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, District Hospital Donauwörth, Donauwörth, Germany
| | - Maria Panzirsch
- Department of Psychiatry, Psychotherapy and Psychosomatics, District Hospital Donauwörth, Donauwörth, Germany
| | - Max Schmauß
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Augsburg and District Hospital Augsburg, Augsburg, Germany
| | - Silvia Krumm
- Department of Psychiatry II, University of Ulm and District Hospital Günzburg, Ulm, Germany
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Brydges S, Rennick-Egglestone S, Anderson C. Men's views of antidepressant treatment for depression, and their implications for community pharmacy practice. Res Social Adm Pharm 2019; 16:1041-1049. [PMID: 31706951 DOI: 10.1016/j.sapharm.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Men with depression can express and navigate their condition differently to women. Understanding this population's needs, and experiences, can help healthcare professionals better support these patients. There is a lack of knowledge in this area, and no studies have explored men's depression in the context of community pharmacy. OBJECTIVES Explore views of men around their medication for the treatment of depression and the role of community pharmacy in their treatment. SETTING United Kingdom (UK) primary care. METHOD Semi-structured in-depth interviews were conducted. Eligible participants were male, aged 18-65 years, and treating depression with antidepressants. Participants were recruited through 5 UK pharmacies (via the pharmacist or poster recruitment) and a UK University (poster recruitment). A thematic approach was used for analysis. RESULTS 14 men aged 26-61 years, predominantly of white ethnicity were interviewed. Key themes were found. The theme 'Antidepressant's attributions to benefits' highlighted all men noticed benefits when taking antidepressants, but held uncertainty on what extent their antidepressants caused this. The themes 'Views of pharmacist's role influences engagement', and 'Influence of cognitive state upon healthcare interactions' demonstrated men were not inclined to discuss concerns with the community pharmacist. These men didn't see this as the pharmacist's role, nor had these men given cognitive space to evaluate their treatment beliefs or information needs. Yet the theme 'Reflection of support and information needs' shows men did have unmet information and support needs. This also links into the 'Hegemonic Masculinity and taking antidepressants' theme, where taking antidepressants could challenge ones masculinity. CONCLUSION Community pharmacists should create opportunities for men to engage in conversations around their antidepressants and wider support. Men, as a requisite for engagement, will need to see such interactions as within the community pharmacists' remit, and as part of a collaborative healthcare system.
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Affiliation(s)
- Sarah Brydges
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK.
| | - Claire Anderson
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK.
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