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A biopsychosocial model as a guide for psychoeducation and treatment of depression
Author(s) -
Schotte Chris K.W.,
Van Den Bossche Bart,
De Doncker Dirk,
Claes Stephan,
Cosyns Paul
Publication year - 2006
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20177
Subject(s) - biopsychosocial model , psychoeducation , depression (economics) , psychotherapist , psychology , clinical psychology , psychiatry , psychological intervention , economics , macroeconomics
Effective treatment of severe or chronic unipolar depression requires the combination of pharmacological and psychotherapeutic interventions, and demands a theoretical paradigm integrating biological and psychosocial aspects of depression. Supported by recent research, we propose in our article a biopsychosocial diathesis–stress model of depression. Its basic aim is psychoeducational: to provide therapists, patients, and their environment a constructive conceptual framework to understand depressive complaints, vulnerability, and stress. The core of the model consists of the concept of psychobiological vulnerability, which is determined by risk factors—of a biogenetic, psychological, somatic, and societal nature—and by protective factors. Life events with an idiosyncratic, stress‐inducing value interact with this vulnerability, triggering severe or chronic distress that affects the individual's resilience and leads to symptoms of depression. The pathogenesis of depression is symbolized by a negative downward loop, in which interactions among symptoms, vulnerability, and stressors drive the patient toward a depressive condition. Moreover, experiencing recurrent depression influences psychobiological vulnerability, the occurrence of stressors, and tremendously increases the risk of further relapse. The model stresses the self‐evident integration of biological and psychological therapeutic interventions that need to focus on symptom reduction and on relapse prevention. Moreover, it offers the patient and therapist a psychoeducational context in which the individual's vulnerability and depressive symptoms can be treated. Finally, applications of the depression model as a therapeutic approach to severe depression in the phases of remoralization, symptom reduction, and relapse prevention are presented. Depression and Anxiety 23:312–324, 2006. © 2006 Wiley‐Liss, Inc.