TY - JOUR
KW - Adjustment Disorders/classification/diagnosis/ethnology/psychology
KW - Adolescent
KW - Adult
KW - Aged
KW - Depressive Disorder/classification/diagnosis/ethnology/psychology
KW - Ego
KW - Female
KW - Hispanic Americans/psychology
KW - Humans
KW - Internal-External Control
KW - Interview, Psychological
KW - Male
KW - Medical History Taking
KW - Middle Aged
KW - New York City
KW - Patient Acceptance of Health Care
KW - Patient Satisfaction
KW - Personality Assessment/statistics & numerical data
KW - Pilot Projects
KW - Primary Health Care
KW - Psychometrics
KW - Psychotherapy
KW - Referral and Consultation
KW - Sick Role
KW - Urban Population
AU - A. Karasz
A1 - 
AB - 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.
BT - The Journal of nervous and mental disease
C5 - Healthcare Disparities
CP - 4
CY - United States
DO - 10.1097/NMD.0b013e31816a496e
IS - 4
JF - The Journal of nervous and mental disease
N2 - 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.
PP - United States
PY - 2008
SN - 1539-736X; 0022-3018
SP - 289
EP - 296
EP - 
T1 - The development of valid subtypes for depression in primary care settings: A preliminary study using an explanatory model approach
T2 - The Journal of nervous and mental disease
TI - The development of valid subtypes for depression in primary care settings: A preliminary study using an explanatory model approach
U1 - Healthcare Disparities
U2 - 18414123
U3 - 10.1097/NMD.0b013e31816a496e
VL - 196
VO - 1539-736X; 0022-3018
Y1 - 2008
ER -