"I am strong and I can get on with my life": The subjective experience of recovery of patients treated for depression.

OBJECTIVE: : The aim of the study was to characterize the subjective experience of recovery from depression based on the perspective of those who suffer from it. METHOD: : Forty participants from two South American countries, who had been or were currently being treated for depression, took part in semi-structured and in-depth interviews. Most participants were female (78%), with ages ranging from 22 to 63 years. Interviews were analyzed using Grounded Theory, creating a hierarchy of categories that represent participants' experience of recovery. The categories were subsequently organized around an emergent central phenomenon. RESULTS: : "Transformation of the experience of the depressed self" was constructed as the main phenomenon that accounts for the subjective understanding of recovery. This transformation consists in an increase in self-acceptance, self-appreciation, and auto-biographical contextualization, coupled with an increase in agency and empowerment. CONCLUSION: : Recovery is experienced as a multidimensional process that goes beyond the absence of symptoms. Change is experienced as a result of active self-management and commitment. The relevance of person-centered perspectives and their subjectivity for managing depression is discussed.

Del malestar a la depresión: dinámicas en la construcción del significado personal de la experiencia de la depresión / From Discomfort to Depression: Dynamics in Building Personal Meaning from the Depressive Experience

Resumen Objetivo: Comprender las dinámicas mediante las cuales los pacientes significan su experiencia de la depresión. Metodología: Se utilizó una metodología cualitativa, basada en la Teoría Fundamentada. Se realizaron entrevistas semiestructuradas a 10 pacientes diagnosticados de un trastorno del ánimo con episodio depresivo, por el que habían estado en tratamiento psicoterapéutico previamente. Las entrevistas fueron analizadas desde un enfoque descriptivo-relacional, para reconocer las principales unidades temáticas referidas por los participantes y luego identificar sus relaciones y significados subyacentes. Resultados: El significado de la experiencia de la depresión se reveló como un proceso denominado "Construcción subjetiva de la experiencia de la depresión", caracterizado por tres momentos. (1) "La experiencia de un malestar sin nombre"; (2) "Anclaje de la experiencia del paciente en la palabra depresión"; (3) "Apropiación de la experiencia de la depresión". Conclusión: la experiencia de la depresión se presenta como un proceso dinámico de interacción entre el malestar subjetivo y la construcción de significados asociados a él; transitando de una experiencia desconcertante observada en el cuerpo, el ánimo y/o lo conductual, hacia una experiencia elaborable discursivamente, a través de una referencia semántica (depresión) que integra los significados y origina un proceso de apropiación de lo que implica para cada individuo tener depresión o estar deprimido.

Abstract Objective: To understand the dynamics by which patients signify their depressive experience. Methodology: A qualitative methodology was used, based on the Grounded Theory. Semi-structured interviews were conducted with 10 patients diagnosed with a mood disorder with depressive episode, who had been in a psychotherapy treatment about it. The interviews were analyzed from a descriptive-relational approach, recognizing the main thematic units referred by the participants, and then identifying their relationships and underlying meanings. Results: The meaning of "depression" experience was revealed as a process, named "subjective construction of depression experience", characterized by three moments: (1) "The experience of an unnamed discomfort"; (2) "Anchoring the patient's experience in the word depression"; (3) "Appropriation of depression experience". Conclusion: The depressive experience is presented as a dynamic process of interaction between subjective discomfort and the construction of meanings associated to it. Transitioning from a disconcerting experience observed on their body, mood, and/or their behaviour, to something available to be elaborated discursively, through a semantic reference (depression) that integrates them, originates a process of appropriation about what it implies for each individual to be depressed or have depression.

Estilos de personalidad dependiente y autocrítico: desempeño cognitivo y sintomatología depresiva / Dependent and self-critical personality styles: Cognitive performance and depressive symptomatology

Resumen El presente estudio explora la relación entre las dimensiones de personalidad dependiente y autocrítica, con los déficits emocionales, cognitivos y sociales asociados a la sintomatología depresiva. La muestra del estudio la conformaron 91 estudiantes universitarios pertenecientes a la Pontificia Universidad Católica de Chile y a la Universidad de Chile, con edades comprendidas entre los 18 y 24 años. Para explorar el estado emocional de los participantes se utilizaron los test Inventario de Depresión de Beck (BDI) y Depressive Experiences Question naire (DEQ). Con el fin de evaluar el desempeño cognitivo, se utilizaron: una tarea tipo Stroop y la prueba de Tiempo de Reacción Serial (SSRT), y para evaluar el nivel de mentalización, la tarea de reconocimiento facial Reading the Mind in the Eyes Task (RMET) de Baron-Cohen. Se encontraron correlaciones significativas entre las dimensiones dependencia y autocrítica, la sintomatología depresiva y el desempeño cognitivo de los participantes.

Abstract This study examines the relationship between the dependent and self-criticism Cognitive dimensions of personality with emotional, cognitive and social deficits associated with depres-sive symptoms. The sample included 91 college students, aged 18 to 24, from Pontificia Universidad Católica de Chile and Universidad de Chile. The Beck Depression Inventory (BDI) and the Depressive Experiences Questionnaire (DEQ) tests were used in order to explore the emotional state of the participants. A Stroop task and a Serial Reaction Time (SSRT) test were used in order to assess cognitive performance. In turn, the Reading the Mind in the Eyes Task (RMET) face recognition task, by Baron-Cohen, was used to assess the mentalising capacity. Sig nificant correlations were found between dependency and self-criticism dimensions, depressive symptoms and cognitive performance of the participant.

[Barriers restricting postpartum depression treatment in Chile]. / Barreras de acceso a tratamiento de la depresión posparto en Centros de Atención Primaria de la Región Metropolitana: un estudio cualitativo.

BACKGROUND: In Chile, postpartum depression is a prevalent and disabling condition. Universal screening is available but has not been translated into better treatment rates, suggesting the existence of access barriers. AIM: To describe access barriers to postpartum depression treatment in six primary health care clinics in Metropolitan Santiago, Chile. MATERIAL AND METHODS: Twenty women with postpartum depression and 18 primary health care professionals were subjected to a semi-structured interview. A qualitative methodology based on Grounded Theory was used. RESULTS: There are user associated barriers such as lack of knowledge about the disease, a negative conceptualization and rejection of available treatment options. There are also barriers associated with poor network support and some features of the health care system such as long waiting times and lack of coordination between clinical and administrative decisions. CONCLUSIONS: Patient and provider related barriers restricting treatment of postpartum depression were identified.

Barreras de acceso a tratamiento de la depresión posparto en Centros de Atención Primaria de la Región Metropolitana: un estudio cualitativo / Barriers restricting postpartum depression treatment in Chile

Background: In Chile, postpartum depression is a prevalent and disabling condition. Universal screening is available but has not been translated into better treatment rates, suggesting the existence of access barriers. Aim: To describe access barriers to postpartum depression treatment in six primary health care clinics in Metropolitan Santiago, Chile. Material and Methods: Twenty women with postpartum depression and 18 primary health care professionals were subjected to a semi-structured interview. A qualitative methodology based on Grounded Theory was used. Results: There are user associated barriers such as lack of knowledge about the disease, a negative conceptualization and rejection of available treatment options. There are also barriers associated with poor network support and some features of the health care system such as long waiting times and lack of coordination between clinical and administrative decisions. Conclusions: Patient and provider related barriers restricting treatment of postpartum depression were identified.