抑鬱是一種常見的精神健康問題，足以負面影響我們感受、思考和行為的方式 (American Psychiatric Association, 2017)。抑鬱也是世界上導致殘疾的一個重要原因。據估計，世界上約有4.4% 的人受苦於抑鬱 (World Health Organization, 2017)。抑鬱之出現，可能涉及生理因素（e.g., 遺傳因素、化學物質失衡）和心理社會因素（e.g., 缺乏自尊、環境壓力、遭遇暴力、貧困和心理創傷）。事實上，一些學者認為抑鬱症患者可能是一個異質群體 (Goldberg, 2011)。抑鬱症患者可能接受藥物治療、心理社會治療及/或腦電盪療法（ECT）。現時，社會上已發展了許多用以治療抑鬱症的藥物。雖然部分抑鬱症患者可以從這些藥物治療中得益，但並非所有患者都對藥物有良好反應。部分藥物也有相當顯著的副作用 (Khawam, Laurencic, & Malone, 2006)。此外，認知行為治療法（CBT）用於抑鬱症的治療，已經有很強的實證支持。一些形式的自我幫助介入和心理教育也可能帶來幫助 (Cuijpers, Donker, van Straten, Li, & Andersson, 2010)。儘管精神健康領域普遍強調生理心理社會模式的重要性，但治療抑鬱症的趨勢是：藥物治療往往更普遍，而心理社會介入的角色有時則被忽視 (Fung & Chan, 2019)。抑鬱症是一個重大公共衛生問題，可造成巨大的社會、經濟和個人成本，故必須得到社會各界更多的關注。污名和誤解，也是令患者在接受精神健康照護服務前卻步的一些障礙。
Depression is a common mental health problem which could negatively affect how we feel, think and act (American Psychiatric Association, 2017). Depression is also a major leading cause of disability in the world. About 4.4% of the world population are estimated to suffer from depression (World Health Organization, 2017). The development of depression may involve biological factors (e.g., genetic factors, chemical imbalance) and psychosocial factors (e.g., low self-esteem, stressful environment, exposure to violence, poverty and psychological trauma). In fact, some scholars also suggested that patients with depression may be a heterogeneous group (Goldberg, 2011). Patients with depression may receive medication treatments, psychosocial treatments and/or electroconvulsive therapy (ECT). A number of medications have been developed to treat depression. While some patients with depression could benefit from such medication treatments, not all patients respond well. Some medications also have considerable side effects (Khawam, Laurencic, & Malone, 2006). Besides, the use of cognitive-behavioral therapy (CBT) in the treatment of depression has strong empirical support (Butler, Chapman, Forman, & Beck, 2006). Some forms of self-help intervention and psychoeducation may be helpful as well (Cuijpers, Donker, van Straten, Li, & Andersson, 2010). Although the biopsychosocial model is commonly emphasized in the mental health field, the trends in the treatment for depression are that: medication treatments are more commonly used and the role of psychosocial interventions is sometimes overlooked. As a major public health issue which could result in large social, economic and personal costs, depression should receive more attention in our society. Stigma and misunderstanding have been barriers for persons with depression to receive mental health care services.
American Psychiatric Association, . (2017). What Is Depression?
The American Psychiatric Association develops this material in order to provide an introduction to the symptoms, risk factors and treatment of depression. Some self-help resources were also highlighted. 引文
Kelland, K. (2011, 2011-08-15, January 01). Study links persistent depression to childhood abuse. Reuters.
There are many etiological risk factors which play an important role in the development of depression. This report discusses the link between depression and childhood maltreatment. Childhood abuse survivors are twice more likely to suffer from persistent and recurrent depression. 引文
Klass, P. (2012, 2012-05-07, January 01). Parents’ depression linked to problems in children. New York Times.
Depression is more than just a personal mental health problem. It also affects the family members and friends of the depressed person. This article describes how untreated parental depression could lead to negative outcomes in children. It was said that if parental depression can be treated, the entire family can benefit. 引文
廖淑華. (2018, 2018-08-10, January 01). 【逃出恐懼鬥室•上】抑鬱少女：在精神病房待得越久會越「癲」. HK01.
This American drama film describes the experience of the main character, Helen, who suffered from depression despite the fact that she was a successful lady and that she had a husband who loved her and their daughter so much. She had many depressive symptoms, such as sleep problems and suicide attempts. 引文
Cuijpers, P. et al. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychological Medicine, 40(12), 1943–1957.
Medications and psychotherapy can be very effective in the treatment for depression, but not all patients can access such services. This systematic review examines whether guided self-help for depression and anxiety could be as effective as face-to-face interventions. It was concluded that guided self-help and face-to-face interventions could have comparable effects. Persons who could not access face-to-face interventions may consider the use of guided self-help. 引文
Fung, H. W. & Chan, C. (2019). A preliminary study of the clinical differences between dissociative and nondissociative depression in Hong Kong: Implications for mental health practice. Social Work in Health Care, 58(6), 564–578.
This paper discusses the clinical differences between dissociative and nondissociative depression and suggests that there is a subgroup of people with depression that is characterized by a high level of dissociation. This subgroup of people with depression may have higher occurrences of psychosocial etiological risk factors and psychosocial-related symptoms. They may benefit more from psychosocial interventions than from pharmaceutical treatments. 引文
Goldberg, D. (2011). The heterogeneity of “major depression.” World Psychiatry, 10(3), 226–228.
This paper discusses the concept of major depression and challenges the diagnostic label of depression as well as the belief that major depression is a homogeneous entity. The author suggested that there may be different forms of depression. Different forms of depression may be associated with different biopsychosocial factors and therefore may require different intervention approaches. 引文
Goldman, L. S. et al. (1999). Awareness, diagnosis, and treatment of depression. Journal of General Internal Medicine, 14(9), 569–580.
This early review article provides an overview of the epidemiology, burden, diagnosis, comorbidity, and treatment of depression. The authors suggested that education efforts destigmatization and improvement mental health service access are needed. 引文
Khawam, E. A. et al. (2006). Side effects of antidepressants: An overview. Cleveland Clinic Journal of Medicine, 73(4), 351.
This paper overviews the adverse effects and risks of antidepressant medications (e.g., weight gain, dry mouth, sedation, sexual dysfunction, increased suicide risk). Newer medications were said to be safer and better tolerated. 引文
Beck, et al. (2009). Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press.
Written after 40 years of the first edition, the famous psychiatrist Aron Beck and his colleague Brad Alford introduces updated scientific findings in the literature. This book helps readers understand depression as a cognitive disorder. The biomedical aspects of depression were also highlighted. 引文
World Health Organization, . (2017). Depression and other common mental disorders: Global health estimates. Geneva: World Health Organization.
Published by the World Health Organization, this resource introduces and describes the definitions, global prevalence and health loss of common mental disorders, including depressive disorders. 引文
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