The development of valid subtypes for depression in primary care settings: a preliminary study using an explanatory model approach.

The Journal of Nervous and Mental Disease
Alison Karasz

Abstract

A persistent theme in the debate on the classification of depressive disorders is the distinction between biological and environmental depressions. Despite decades of research, there remains little consensus on how to distinguish between depressive subtypes. This preliminary study describes a method that could be useful, if implemented on a larger scale, in the development of valid subtypes of depression in primary care settings, using explanatory models of depressive illness. Seventeen depressed Hispanic patients at an inner city general practice participated in explanatory model interviews. Participants generated illness narratives, which included details about symptoms, cause, course, impact, health seeking, and anticipated outcome. Two distinct subtypes emerged from the analysis. The internal model subtype was characterized by internal attributions, specifically the notion of an "injured self." The external model subtype conceptualized depression as a reaction to life situations. Each subtype was associated with a distinct constellation of clinical features and health seeking experiences. Future directions for research using explanatory models to establish depressive subtypes are explored.

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Citations

May 18, 2010·Journal of General Internal Medicine·Ronald M EpsteinDebora A Paterniti
Jul 29, 2009·BMC Family Practice·Arja LehtiBengt Mattsson
Jan 7, 2011·Journal of the American Board of Family Medicine : JABFM·Erik Fernandez Y GarciaRichard L Kravitz
Apr 24, 2012·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Alison KaraszJoanne Reeve
Sep 3, 2013·Behavioural Brain Research·Christopher F Sharpley, Vicki Bitsika
Nov 1, 2013·Behavioural Brain Research·Christopher F Sharpley, Vicki Bitsika
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Nov 1, 2016·Medicine, Health Care, and Philosophy·Annette Sofie DavidsenSusanne Reventlow

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