General Practitioner Perceptions and Practice Related to Adolescent                 Depressive Presentations

Vandana, Jyoti; Ambelas, Aris

doi:10.1177/1359104504043916

Cited by 8 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are a number of reasons why GPs might not readily adopt this new role. Although GPs believe that depressive presentations among teenagers are becoming increasingly common (Vandana and Ambelas, 2004) and do identify most of those with severe psychological morbidity, they also fail to identify the majority of those with depressive disorders (Angold et al ., 1999). There is some evidence that GPs spend less time in consultation with young people (Jacobson et al ., 2002) and many practitioners feel that teenagers are hard to communicate with and worry about over-medicalizing their lives (MacFarlane and McPherson, 1995; Iliffe et al ., 2004).…”

Section: Introductionmentioning

confidence: 99%

General practitioners’ understanding of depression in young people: qualitative study

Iliffe¹,

Williams²,

Fernández

et al. 2008

PHC

View full text Add to dashboard Cite

Background: Depression in young people is not necessarily self-limiting, and is frequently associated with affective disorders and impaired psychosocial functioning in adult life. Early recognition of and response to depression in teenagers could be an important task for general practitioners (GPs), but there are multiple obstacles to achieving this. Objectives: To explore GPs perceptions of the opportunities and difficulties of working with teenagers, and of specifically recognizing and responding to depression. Setting and participants: Nine GPs who had taken part in a developmental project on diagnosing and treating depression in young people. All worked in an Inner London Medical Centre. Methods: Semi-structured interviews transcribed and analysed thematically. Findings: Two over-arching themes that emerged from the interviews were that teenagers were perceived as being qualitatively different from adults in the ways they used general practice, and that GPs were uncomfortable with making a diagnosis of depression in young people. Within the first theme, we identified sub-themes, including failure of teenagers to engage with services, parental involvement, complex presentations and lack of time. Within the second theme, the sub-themes were surprise, normalization of depressed mood and challenge to the validity of psychiatric diagnosis in this age group. Conclusions: Professional development in general practice that addresses this topic needs to modify two perceptions; that depressed mood is in some sense 'normal' in this age group, and that teenagers are so different in their use of services that the management of depression (if it is recognized at all) is problematic.

show abstract

Section: Introductionmentioning

confidence: 99%

General practitioners’ understanding of depression in young people: qualitative study

Iliffe¹,

Williams²,

Fernández

et al. 2008

PHC

View full text Add to dashboard Cite

show abstract

“…Although GPs believe that depression is becoming increasingly common among teenagers 12 and do identify and react to most of those with severe psychological morbidity, they also fail to identify the majority of those with depressive disorders. 9 There is some evidence that GPs spend less time in consultations with young people; 10 some practitioners feel that teenagers are hard to communicate with and worry about overmedicalising their lives.…”

mentioning

confidence: 99%

Treading a fine line: is diagnosing depression in young people just medicalising moodiness?

Iliffe

Williams²,

Fernández³

et al. 2009

Br J Gen Pract

View full text Add to dashboard Cite

“…At present, there is significant variation in the abilities of primary care providers to effectively identify and manage mental health problems. In a recent issue of CCPP, Vandana and Ambelas (2004) found that GPs appear to recognize increased unhappiness among adolescents, yet they are hesitant to diagnose and treat depressive presentations. How can this be best accomplished?…”

Section: Arlene Vetere and The Countless Others Who Have Shaped My Tmentioning

confidence: 98%

Tenth Anniversary Editorial

Long¹,

Lask²,

Rushton³

et al. 2005

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

Bernadette's invitation to predict what might be of interest and concern to practitioners 10 years hence is both provocative and challenging.It mirrors a question I have been debating with colleagues and trainees these past 20 years: what is it that we pay attention to now, that we did not pay attention to in the same way, if at all, 10 years ago? When asking the question in hindsight, our discussions have tracked changes in emphasis, theoretical developments, fashionable trends, new areas of research and enquiry, policy changes, and the occasional 'ah ha!' experience. Our emotional responses have often been powerful, ranging from guilt and consternation over what we might have missed in our clinical practice, to pleasure and feelings of inclusion when part of a growing clinical interest group.Of course, it is easier with hindsight to see patterns and appreciate how powerful vested interests can dominate or suppress developments in thinking and practice, but to look ahead in this way, is something else -we reveal our wishes and hopes for the families and children we serve, and the future of our professional groups.As I have looked back in this way over the years, there is one dominant thread -that of the continuing impact of trauma and abuse on individuals, their relationships and within their community contexts. Although I travel hopefully in my clinical work, and put my energy into promoting resilience and the development of supportive relationships, I try not to underestimate the significance of maltreatment. For me, this underpins many of the psychological symptoms that we currently classify separately, almost treating them as if they were separate phenomena. Over the years, I have seen these descriptions used as if they constituted explanations, and sometimes as if they were evidence of separate disease processes. I have found that the practice of clinical formulation, based on progressive hypothesizing, helps to keep me close to the experiences of the people I work with, and accountable for my use of theory. I hope that psychotherapy practices around formulation will become more user-friendly and more broadly accessible and used within all our mental health services.As you can see, I think diagnostic systems miss the point. Equally, I think single-school theories of human development cannot rise to the challenge of explaining the effects of some common human dilemmas, such as living with domestic violence or living in violent communities, or with long-term drinking problems, or with the effects of poverty and political oppression. I hope we shall move towards keener exploration of the integration of theory. We may well see the rise of the so-called energy therapies in this context, as we pay more attention to the embodied aspects of distress. However, I think the recent turn to Clinical Child Psychology and Psychiatry

show abstract

General Practitioner Perceptions and Practice Related to Adolescent Depressive Presentations

Cited by 8 publications

References 3 publications

General practitioners’ understanding of depression in young people: qualitative study

General practitioners’ understanding of depression in young people: qualitative study

Treading a fine line: is diagnosing depression in young people just medicalising moodiness?

Tenth Anniversary Editorial

Contact Info

Product

Resources

About