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Experiences Of Depression

Author: Matthew Ratcliffe
Publisher: Oxford University Press, USA
ISBN: 0199608970
Size: 60.17 MB
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Experiences of Depression is a philosophical exploration of what it is like to be depressed. In this important new book, Matthew Ratcliffe develops a detailed account of depression experiences by drawing on work in phenomenology, philosophy of mind, and several other disciplines. In so doing, he makes clear how phenomenological research can contribute to psychiatry, by helping us to better understand patients' experiences, as well as informingclassification, diagnosis, and treatment. This book will be of interest to anyone seeking to understand and relate to experiences of depression, including philosophers, psychiatrists, clinical psychologists,therapists, and those who have been directly or indirectly affected by depression.

Behind The Screen

Author: Johan Lundgren
Publisher: Linköping University Electronic Press
ISBN: 9176854027
Size: 34.65 MB
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Introduction The prevalence of depressive symptoms in persons with heart failure is higher than in age- and gender-matched populations not suffering from heart failure. Heart failure in itself is associated with an unpredictable trajectory of symptoms, a poor prognosis, high mortality and morbidity, and low health-related quality of life (HrQoL). With the addition of depressive symptoms to heart failure the negative health effects increase further. Though the negative consequences of depressive symptoms in heart failure are well known, there is a knowledge gap about the course of depressive symptoms in heart failure and about how to effectively manage these symptoms. Pharmacological treatment with serotonin reuptake inhibitors has not been able to demonstrate efficacy in persons with heart failure. In a few studies, cognitive behavioural therapy (CBT) delivered face-to-face, has demonstrated effects on depressive symptoms in persons with heart failure. However, currently there are barriers in delivering face-to-face CBT as there is a lack of therapists with the required training. As a solution to this, the use of Internet-based CBT (ICBT) has been proposed. ICBT has been shown to be effective in treatment of mild and moderate depression but has not been evaluated in persons with heart failure. Aim The overall aim of this thesis was to describe depressive symptoms over time and to develop and evaluate an ICBT intervention to treat depressive symptoms in persons with heart failure. Design and Methods The studies in this thesis employ both quantitative (Studies I, II and III) and qualitative (Studies II and IV) research methods. The sample in Study I (n=611) were recruited in the Netherlands. The participants (n=7) in Study II were recruited via advertisements in Swedish newspapers. Studies III and IV used the same cohort of participants (Study III n=50, Study IV n=13). These participants were recruited via an invitation letter sent to all persons who had made contact with healthcare services in relation to heart failure during the previous year, at the clinics of cardiology or medicine in four hospitals in southeast Sweden. Study I had a quantitative longitudinal design. Data on depressive symptoms was collected at baseline (discharge from hospital) and after 18 months. Data on mortality and hospitalisation was collected at 18 and 36 months after discharge from hospital. Study II employed three differentBehind the Screen2patterns of design, as follows: I) The development and context adaptation of the ICBT program was based on research, literature and clinical experience and performed within a multi-professional team. II) The feasibility of the program from the perspective of limited efficacy and function was investigated with a quantitative pre-post design. III) Participants’ experience of the ICBT program was investigated with a qualitative content analysis. Data on depressive symptoms was collected pre and post intervention. The time used for support and feedback was logged during the intervention, and qualitative interviews were performed with the participants after the end of the intervention. Study III was designed as a randomised controlled trial. A nine-week ICBT program adapted to persons with heart failure and depressive symptoms was tested against an online moderated discussion forum. Data on depressive symptoms, HrQoL and cardiac anxiety was collected at baseline (before the intervention started) and after the end of the intervention (approximately 10 weeks after the start of the intervention). Study IV had a qualitative design to explore and describe participants’ experiences of ICBT. The participants were recruited from within the sample in Study III and all had experience of ICBT. Data collection occurred after the ICBT program ended and was carried out using qualitative interviews by telephone. Results The mean age of the samples used in this thesis varied between 62 and 69 years of age. Concerning the symptom severity of heart failure, most persons reported New York Heart Association (NYHA) class II (40-57%) followed by NYHA class III (36-41%). Ischaemic heart disease was the most common comorbidity (36-43%). The vast majority had pharmacological treatment for their heart failure. Six percent of the persons in Study I used pharmacological antidepressants. In Studies II and III, the corresponding numbers were 43% and 18% respectively. Among persons hospitalised due to heart failure symptoms, 38% reported depressive symptoms. After 18 months, 26% reported depressive symptoms. Four different courses of depressive symptoms were identified: 1) Non-depressed 2) Remitted depressive symptoms. 3) Ongoing depressive symptoms. 4) New depressive symptoms. The highest risk for readmission to hospital and mortality was found among persons in the groups with ongoing and new depressive symptoms. A nine-week ICBT program consisting of seven modules including homework assignments on depressive symptoms for persons with heart failure was developed and tested. The RCT study (Study III) showed no significant difference in depressive symptoms between ICBT and a moderated discussion forum. Within-group analysis of depressive symptoms demonstrated a significant decrease of depressive symptoms in the ICBT group but not in the discussion forum group. The participants’ experience of ICBT was described in one theme: ICBT- an effective, but also challenging tool for self-management of health problems. This theme was constructed based on six categories: Something other than usual healthcare; Relevance and recognition; Flexible, understandable and safe; Technical problems; Improvements by live contact; Managing my life better. Conclusion After discharge from hospital, depressive symptoms decrease spontaneously among a large proportion of persons with heart failure, though depressive symptoms are still common in persons with heart failure that are community dwelling. Depressive symptoms in persons with heart failure are associated with increased risk of death and hospitalisation. The highest risks are found among persons with long-term ongoing depressive symptoms and those developing depressive symptoms while not hospitalised. ICBT for depressive symptoms in heart failure is feasible. An intervention with a nine-week guided self-help program with emphasis on behavioural activation and problem-solving skills appears to contribute to a decrease in depressive symptoms and improvement of HrQoL. When ICBT is delivered to persons with heart failure and depressive symptoms the participants requests that the ICBT is contextually adapted to health problems related to both heart failure and depressive symptoms. ICBT is experienced as a useful tool for self-care and something other than usual healthcare. ICBT also requires active participation by the persons receiving the intervention, something that was sometimes experienced as challenging.

Depression Emotion And The Self

Author: Matthew Ratcliffe
Publisher: Andrews UK Limited
ISBN: 1845407725
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This volume addresses the question of what it is like to be depressed. Despite the vast amount of research that has been conducted into the causes and treatment of depression, the experience of depression remains poorly understood. Indeed, many depression memoirs state that the experience is impossible for others to understand. However, it is at least clear that changes in emotion, mood, and bodily feeling are central to all forms of depression, and these are the book’s principal focus. In recent years, there has been a great deal of valuable philosophical and interdisciplinary research on the emotions, complemented by new developments in philosophy of psychiatry and scientifically-informed phenomenology. The book draws on all these areas, in order to offer a range of novel insights into the nature of depression experiences. To do so, it brings together a distinguished group of philosophers, psychiatrists, anthropologists, clinical psychologists and neuroscientists, all of whom have made important contributions to current research on emotion and/or psychiatric illness.

Philosophical Issues In Psychiatry Iii

Author: Kenneth S. Kendler
Publisher: Oxford University Press, USA
ISBN: 0198725973
Size: 32.34 MB
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Psychiatry has long struggled with the nature of its diagnoses. The problems raised by questions about the nature of psychiatric illness are particularly fascinating because they sit at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. In being the only medical specialty that diagnoses and treats mental illness, psychiatry has been subject to major changes in the last 150 years. This book explores the forces that have shaped these changes and especially how substantial "internal" advances in our knowledge of the nature and causes of psychiatric illness have interacted with a plethora of external forces that have impacted on the psychiatric profession. It includes contributions from philosophers of science with an interest in psychiatry, psychiatrists and psychologists with expertise in the history of their field and historians of psychiatry. Each chapter is accompanied by an introduction and a commentary. The result is a dynamic discussion about the nature of psychiatric disorders, and a book that is compelling reading for those in the field of mental health, history of science and medicine, and philosophy.

Der Sinn Des Wahnsinns Psychische St Rungen Verstehen

Author: Neel Burton
Publisher: Springer-Verlag
ISBN: 3827427746
Size: 70.70 MB
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Was es heißt, verrückt zu sein Die Zahl psychischer Erkrankungen nimmt vor allem in den Industrieländern stetig zu. Auch in Deutschland leiden immer mehr Menschen etwa an Depressionen oder Angststörungen. Psychische Störungen können uns alle betreffen: Sie sind in der Mitte der Gesellschaft angekommen, auch wenn ihr Wesen und ihre Ursachen nach wie vor Rätsel aufgeben. Das Buch von Neel Burton beschreibt und erläutert die wichtigsten dieser Störungen und rückt sie zugleich in ein neues Licht: Könnte der „Wahnsinn“ einen tieferen Sinn für uns Menschen haben? Der Sinn des Wahnsinns will auch eine Debatte über psychische Störungen anstoßen. Das Buch soll das Interesse an der Thematik wecken und den Leser dazu anregen, über jene geheimnisvolle Seite der Seele nachzudenken. Fragen gibt es genug: Was ist beispielsweise Schizophrenie? Warum ist sie so verbreitet? Warum tritt sie nur bei Menschen auf und nicht bei Tieren? Was kann uns dies über Körper und Seele sagen, über Sprache und Kreativität, über Musik und Religion? Welche Behandlungsmöglichkeiten gibt es bei Depression? Wie können Menschen lernen, mit Angst umzugehen? Wo liegt die Grenze zwischen psychisch „krank“ und psychisch „normal“? Gibt es einen Zusammenhang zwischen psychischen Störungen und Genialität? Und sind wir alle ein wenig „verrückt“? Einfühlsam und mit zahlreichen Bezügen zu Literatur, Kunst und Philosophie widmet sich Burton den Grundelementen der Persönlichkeit, der Schizophrenie und dem „Preis des Menschseins“, der Depression und dem „Fluch des Starken“, der manisch-depressiven Erkrankung, der Angst und ihrem Zusammenhang mit Freiheit und Tod sowie dem Suizid. Dabei geht er der Frage nach, was uns psychische Störungen über das Wesen des Menschen und über die Bedingungen des menschlichen Daseins verraten können. „Eine fesselnde Lektüre für alle, die einmal einen Blick in die Welt der psychischen Störungen werfen wollen.“ Professor Robert Howard, Vorsitzender des Royal College of Psychiatrists in London

Philosophical Issues In Psychiatry Ii

Author: Kenneth S. Kendler
Publisher: Oxford University Press
ISBN: 0199642206
Size: 78.70 MB
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Psychiatry has long struggled with the nature of its diagnoses. The problems raised by questions about the nature of psychiatric illness are so interesting because they sit at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. This volume brings together a range of experts from psychiatry, psychology, history and philosophy to discuss these issues. The book isinteractive as each individual chapter, written by a different expert, is introduced by the editors and is followed by a comment by another expert. The volume captures the give and take of a dynamic discussion about the nature of psychiatric disorders.

Alternative Perspectives On Psychiatric Validation

Author: Peter Zachar
Publisher: OUP Oxford
ISBN: 0191502049
Size: 11.44 MB
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Many of the current debates about validity in psychiatry and psychology are predicated on the unexpected failure to validate commonly used diagnostic categories. The recognition of this failure has resulted in, what Thomas Kuhn calls, a period of extraordinary science in which validation problems are given increased weight, alternatives are proposed, methodologies are debated, and philosophical and historical analyses are seen as more relevant than usual. In this important new book in the IPPP series, a group of leading thinkers in psychiatry, psychology, and philosophy offer alternative perspectives that address both the scientific and clinical aspects of psychiatric validation, emphasizing throughout their philosophical and historical considerations. This is a book that all psychiatrists, as well as philosophers with an interest in psychiatry, will find thought provoking and valuable.

Re Visioning Psychiatry

Author: Laurence J. Kirmayer
Publisher: Cambridge University Press
ISBN: 1107032202
Size: 12.94 MB
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Revisioning Psychiatry brings together new perspectives on the causes and treatment of mental health problems. The contributors emphasize the importance of understanding experience and explore how the brain, the person, and the social world interact to give rise to mental health problems as well as resilience and recovery.