Mundos vitales de palabras: análisis del sufrimiento adolescente mediante narrativas de malestar / Vital worlds of words: an analysis of adolescent through emotional distress narratives / Mundos vitais de palavras: análise do sofrimento adolescente mediante narrativas de malestar

Resumen (analítico): Las elevadas tasas de evitación/infrautilización de los servicios desalud mental adolescente señalan la preferencia de este colectivo por autoatender sus malestares. Integrar los saberes juveniles mediante un enfoque hermenéutico y de interpretación de narrativas permite esclarecer las razones de dicha preferencia pues da a conocer, a partir del análisis de nosologías legas, los modos en los que la juventud percibe, siente y vivencia el malestar. Se empleó metodología cualitativa, realizándose entrevistas semi-estructuradas a una muestra representativa de 105 informantes catalanes y catalanas. Los resultados muestran un continuum nosológico lego que incluye términos coloquiales y biomédicos articulándolos en distintos gradientes de malestar. Normalización y patologización, así como durabilidad y severidad del malestar, devienen conceptos clave en la conformación del continuum. Observándose diferencias por subgrupos de estudio y género.

Abstract (analytical): Avoiding mental health services indicate that adolescents prefer to engage in self-care to treat their emotional distress. In order to clarify the reasons for this preference the author analyzes the lay nosology that adolescents use to name their emotional distress using a hermeneutic and interpretative approach. The study uses a qualitative methodology through 105 semi-structured interviews with a sample of adolescents and young people from Catalonia (Spain). Results show the existence of a lay nosology continuum, articulating the gradient of emotional distress that forms their vital worlds; temporality, normalization and severity are key concepts that shape this suffering. Differences between subgroups and genders were observed. Recognition of these lay nosologies allows better access to the ways in which emotional distress is perceived, felt and lived. This could lead to improvements in the communication between adolescents and professionals.

Resumo (analítico): A evasão dos serviços de saúde mental indica a preferência dos jovens pelo autoatenção de seus desconfortos. Para esclarecer as razões para esta preferência se analisam as nosologias leigas que os jovens usam para nomear aos seus mal-estares a partir de uma aproximação hermenêutica e interpretativa; foram desenvolvidas entrevistas semiestruturadas a uma amostra de adolescentes e jovens na Catalunha (Espanha). Os resultados desvelam a existência de um continuo nosológico que articula os gradientes de mal-estar emocional dos mundos vitais adolescentes sobre aspectos como temporalidade, normalização e severidade. Foram observados diferentes subgrupos de estudo e de gênero. O conhecimento das nosologias leigas permite um acesso aos modos em que o sofrimento é percebido, sentido e vivido e, como consequência, pode implicar numa melhor comunicação entres jovens e profissionais da saúde.

Social support and gender differences in coping with depression among emerging adults: a mixed-methods study.

BACKGROUND: Depression affects a considerable proportion (12-25 %) of adolescents and so-called emerging adults (ages of 18 and 25). The aims of this study were to explore the relationship between perceived social support and depression in a sample of emerging adults, and subsequently to identify the type of social support young people consider most helpful in dealing with this type of emotional distress. METHODS: A sample of 105 young persons (17-21 years of age) was selected from a previous longitudinal study to create three groups of participants: subjects with a previous diagnosis of depression; subjects with self-perceived but undiagnosed distress compatible with depression; and a group of controls. Qualitative and validated instruments for measuring depressive symptoms (the BDI-II, Beck depression inventory) and social support (the Mannheim interview on social support) were administered. RESULTS: Loss of friendships over time and dissatisfaction with social and psychological support are variables associated with depression in emerging adulthood. Qualitative analysis revealed gender differences both in strategies for managing distress, and in how social support was understood to mitigate depressive symptoms. Male study participants prioritized support that helped them achieve self-control as a first step toward awareness of their emotional distress, while female study participants prioritized support that helped them achieve awareness of the problem as a first step toward self-control. CONCLUSIONS: Treatment for emerging adults with depression should take into account not only the impact of social support, but also gender differences in what they consider to be the most appropriate form of social support for dealing with emotional distress.

Self-care strategies for emotional distress among young adults in Catalonia: a qualitative study.

BACKGROUND: Emotional distress is common in adolescence, and self-care strategies are frequently preferred to address it. The aim of this article is to analyze the self-care strategies among adolescents and young people diagnosed with depression or with self-perceived depressive distress in Catalonia using a qualitative design. METHODS: We analyzed the self-care strategies of 105 young people (17-21 years of age) in Catalonia who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants' narratives on self-care strategies for emotional distress were elicited through in-depth semi-structured interviews. The data were managed using ATLAS-Ti 6.5 software18. We applied hermeneutic theory and the ethnographic method to analyze the interviews. RESULTS: The ten self-care strategies identified in the analysis were grouped into four areas covering the various pathways the young people followed according to whether they had a diagnosis of depression or their depressive distress was self-perceived. The young people feel responsible for their emotional distress and consider that they are capable of resolving it through their own resources. Their strategies ranged from their individuality to sociability expressed through their relationships with others, membership of groups or other self-care strategies (relaxation, meditation, naturopathy, etc.). CONCLUSIONS: The study results highlight the importance of sensitivity in considering young people's self-care strategies as another option in the care of emotional distress.

Sharing Wisdom(s) to Enrich Knowledge: Working in a Transdisciplinary Research Team in Medical Anthropology.

This paper explains our experience working in a transdisciplinary research team focused on adolescence mental health. It introduces briefly the two key theoretical concepts: participation and transdisciplinarity. In order to be followed with a deep description of the methodology and the creation of the two principal materials resulting from our research: a guide of best practices in adolescent mental health, and a documentary film. Showing in a practical way how the research could be enhanced by the sharing of knowledge.

Non-professional-help-seeking among young people with depression: a qualitative study.

BACKGROUND: Adolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible. METHODS: We recruited 105 young persons (17-21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups. RESULTS: Participants' reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services. CONCLUSIONS: A better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context.

[Smoking as a form of self-medication for depression or anxiety in young adults: results of a mixed-methods study]. / El consumo de tabaco como automedicación de depresión/ansiedad entre los jóvenes: resultados de un estudio con método mixto.

Tobacco use and mental health problems in the depression/anxiety spectrum often begin in adolescence as co-occurring phenomena. Epidemiologically, the relationship between them is bidirectional, but in the case of young people it appears to be explained best by the unidirectional self-medication hypothesis. The aim of this study is to explore the relationship between tobacco use, symptoms of depression or anxiety, and the perception of adolescents and young adults concerning tobacco use as a form of self-medication. A sample of 105 young people between the ages of 17 and 21 years was selected from a longitudinal sociological study to create three groups of participants: 1) subjects with a previous diagnosis of depression or anxiety; 2) subjects with self-perceived but undiagnosed distress compatible with depression or anxiety; 3) and a group of control. A mixed quantitative/qualitative questionnaire on substance consumption was administered, as well as the BDI-II depression scale, the GHQ anxiety and depression scales, and the MISS (Mannheim Interview on Social Support) scale. The final results show that the subjects experiencing symptoms of depression or anxiety in adolescence start smoking later than subjects in the control group, and those who smoke give self-medication as the main reason for doing so. The association between habitual tobacco use and BDI scores for depression was not statistically significant for the sample as a whole, only for the male participants (OR: 6,22, IC 95%, 1,06-36,21, p=.042). Anti-smoking campaigns targeting young people should take into consideration their use of tobacco as a form of self-medication for emotional distress.

El consumo de tabaco como automedicación de depresión/ansiedad entre los jóvenes: resultados de un estudio con método mixto / Smoking as a form of self-medication for depression or anxiety in young adults: results of a mixed-methods study

El consumo de tabaco y los problemas de salud mental de tipo depresivo/ansioso son dos fenómenos que suelen iniciarse en la adolescencia y juventud con cierta co-ocurrencia. Ambos fenómenos guardan una relación bidireccional que, en el caso de los jóvenes, la hipótesis de automedicación parece explicar de forma más exhaustiva que otras opciones. El objetivo de este estudio es explorar la relación entre consumo de tabaco, síntomas de depresión y ansiedad y percepción de los jóvenes sobre el uso del tabaco como forma de automedicación. Para ello se seleccionaron 105 jóvenes (17-21 años) de un estudio sociológico longitudinal previo considerando tres grupos de participantes: 1) sujetos con diagnóstico de depresión/ansiedad en anteriores oleadas, 2) sujetos con malestar depresivo/ ansioso autopercibido y sin diagnóstico previo y 3) sujetos control. Se aplicó un cuestionario mixto cuantitativo/cualitativo de consumo de substancias y las escalas BDI-II de depresión y GHQ en su cribado de ansiedad-depresión, así como la escala MISS (Mannheim Interview on Social Support). Los resultados indican que los sujetos afectados por síntomas de depresión/ansiedad en la adolescencia se inician más tarde en el consumo de cigarrillos, pero los que son fumadores alegan principalmente como motivo la automedicación. La asociación entre consumo habitual de tabaco y niveles de depresión de la escala BDI no fue significativa para la muestra general, pero sí para los jóvenes varones (OR: 6,22, IC95%, 1,06-36,21, p=.042). Las iniciativas antitabáquicas dirigidas a los jóvenes deben considerar los problemas de malestar emocional y el consumo de tabaco como forma de automedicación

Tobacco use and mental health problems in the depression/anxiety spectrum often begin in adolescence as co-occurring phenomena. Epidemiologically, the relationship between them is bidirectional, but in the case of young people it appears to be explained best by the unidirectional self-medication hypothesis. The aim of this study is to explore the relationship between tobacco use, symptoms of depression or anxiety, and the perception of adolescents and young adults concerning tobacco use as a form of self-medication. A sample of 105 young people between the ages of 17 and 21 years was selected from a longitudinal sociological study to create three groups of participants: 1) subjects with a previous diagnosis of depression or anxiety; 2) subjects with self-perceived but undiagnosed distress compatible with depression or anxiety; 3) and a group of control. A mixed quantitative/qualitative questionnaire on substance consumption was administered, as well as the BDI-II depression scale, the GHQ anxiety and depression scales, and the MISS (Mannheim Interview on Social Support) scale. The final results show that the subjects experiencing symptoms of depression or anxiety in adolescence start smoking later than subjects in the control group, and those who smoke give selfmedication as the main reason for doing so. The association between habitual tobacco use and BDI scores for depression was not statistically significant for the sample as a whole, only for the male participants (OR: 6,22, IC95%, 1,06-36,21, p=.042). Anti-smoking campaigns targeting young people should take into consideration their use of tobacco as a form of self-medication for emotional distress