Dergi Ara >>
Yıl:2009; Cilt: 10; Sayı: Ek 2>> Özet
Anadolu Psikiyatri Dergisi; 2009;10(Ek 2):60-61
Depresyona yönelik tutumlar ve damgalama
E Özmen
Celal Bayar Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, Manisa
Depresyon ile ilgili damgalama, onun klinik görünümünü, belirlenmesini, tanınmasını, hastanın tedavi uyumunu ve rehabilitasyonunu olumsuz olarak etkileyen bir etkendir. Halkın depresyona yönelik tutumu oldukça olumsuzdur, halk depresyonlu hastayı tehlikeli olarak algılamaktadır. Halk depresyonu aşırı endişe ve ruhsal zayıflık hali olarak düşünmektedir. Halk içinde güçlü bir şekilde depresyonun gelişiminden sosyal sorunları sorumlu tutma eğilimi vardır. Sosyodemografik değişkenlerin depresyona yönelik tutumlara çok az etkisi bulunmaktadır. Depresyonun nedenlerine yönelik inanç ve algıların depresyona yönelik tutumlara bir miktar etkisi bulunmaktadır. Depresyonun bir hastalık olduğunu düşünenler, depresyona kişilik zayıflığından ve sosyal sorunlardan kaynak-lanan bir hastalık olarak bakanlar depresyona yönelik olumsuz tutumlara sahiptir

Halk, depresyonun tedavisinde ruhsal ve sosyal girişimlerin farmakoterapiye göre daha etkili olduğuna ve depresyon tedavisinde kullanılan ilaçların zararlı ve bağımlılık yapıcı olduğuna inanmaktadır. Halk depresyon nedeniyle bir doktora başvurma konusunda isteksizdir ve psikiyatristlerin pratisyen hekimlere göre daha yararlı olduğuna inanmaktadır. Halk depresyonun tedavi edilebilen bir durum olduğunu düşünmektedir. Türkiye’de halkın büyük bir kısmı geleneksel iyileştiricilerin (hoca) depresyonu tedavi edemeyeceğini düşünmektedir. Eğitim düzeyi, depresyonun algılanışı, nedene yönelik inançlar halkın depresyonun tedavisine yönelik tutumlarını etkilemektedir. Eğitim düzeyinin yüksekliği ve depresyonu bir hastalık olarak algılama, depresyonun tedavisi konusun-da olumlu inanç ve görüşlerle ilişkili iken depresif hastaların saldırgan olduğunu düşünme olumsuz inanç ve görüşlerle ilişkilidir

Damgalamaya karşı kampanyalarda ve klinik uygulamalarda “ruhsal ve sosyal girişimlerin farmakoterapiden daha etkili olduğu” ve “antidepresanların zararlı ve bağımlılık yapıcı olduğu” inançları özgül olarak ele alınmalıdır. Kampanyalar eğitim düzeyi ve sosyoekonomik düzeyi yüksek kişilere odaklanmalıdır. Klinik uygulamalarda ve damgalamaya karşı kapmanyalarda depresyon bir hastalık olarak ele alınmalıdır. Diğer yandan halkın depresyonu bir psikososyal sorun gibi ele alma eğilimi de dikkate alınmalıdır. Altta yatan nedeni (biyolojik, ruhsal, sosyal) ne olursa olsun depresyon biyo-psikososyal bir sorun olarak ele alınmalıdır. Aşırı üzüntü ile depresyon arasındaki farklılık ve depresif hastaların saldırgan olmadıkları vurgulanmalıdır.
Attitudes towards depression and stigmatisation
The stigma of depression is a negative factor in its presentation, detection, recognition, treatment adherence and rehabilitation. The public’s attitudes towards depression are highly negative, and public perceived people with depression as dangerous. The public perceive depression as a condition of extreme worry and mental weakness. There is a strong tendency among the lay public to consider social problems as responsible for the development of depression. The socio-demographic characteristics have a minimal impact on attitudes towards depression. Perceptions and beliefs about the causes of depression have some effect on attitudes towards depression. The subjects who consid-ered depression as a disease and who believed that weakness of personality and social problems cause depression have negative attitudes towards it.

The public believes that psychological and social interventions are more effective than pharmacotherapy and that the medicines used in the treatment of depression are harmful and addictive. There is a general reluctance to consult a physician for depression, and psychiatrists are felt to be more helpful than general practitioners. The public view depression as treatable. Most of the public think that traditional healers (hodjas) cannot treat depression in Turkey. Educational level, perception of depression and causal attributions of depression has a major impact on attitudes towards the treatment of depression. A high educational level and the perception of depression as a disease are associated with positive beliefs and opinions about the treatment of depression; but the perception of depressive patients as aggressive is associated with negative beliefs and opinions towards the treatment of depression.

The beliefs that “psychological and social interventions are more effective than pharmacotherapy” and “antidepressants are harmful and addictive” must specifically be taken into account in the clinical practice and in anti-stigma campaigns. Campaigns should primarily focus on people with high educational and socio-economical levels. Depression should be introduced as a disease in clinical practice and anti-stigma campaigns. On the other hand, the public's tendency to conceptualise depression as a psychosocial problem should also be taken into account. Depression should be introduced as a biopsychosocial disease whatever its cause -biological, psychological or social-. The differences between extreme worry and disease and the lack of aggressiveness in depressive patients must be emphasised.

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