Page 148 - Encyclopedia of Nursing Research

DEPRESSion in FAMiLiES n 115

if five out of the following nine symptoms
Depression in FaMilies are present for a minimum of 2 weeks most
of the day, nearly every day: (a) depressed D
mood, (b) loss of interest or pleasure in all
Depression is a major mental health prob- activities, (c) decrease or increase in appetite
lem affecting 25 million Americans and their or significant weight change, (d) insomnia
families. By 2020, depression will be the third or hypersomnia, (e) psychomotor retarda-
leading cause of disability worldwide (http:// tion or agitation, (f) fatigue or loss of energy,
www.int/healthinfo/global_burden_dis- (g) feelings of worthlessness or excessive
ease/2004_report_update/en/index.html). guilt, (h) difficulty concentrating or inde-
Most people suffering from depression live cisiveness, and (i) recurrent thoughts of
with their families, usually their spouses and death, recurrent suicide ideation or attempt
children, and the negative impact of depres- (American Psychiatric Association, 1994).
sion on families has been well documented one of the five symptoms must be depressed
(Bulloch, Williams, Lavorato, & Patten, 2009; mood or loss of interest or pleasure. Together,
Feeny et al., 2009; herr, hammen, & Brennan, these symptoms cause significant functional
2007; Keitner, Archambault, Ryan, & Miller, impairment. in addition to MDD, depres-
2003). nursing has long viewed families as sion is further classified in the Diagnostic and
a context for caring for the individual with Statistical Manual of Mental Disorders, fourth
depression but only recently has focused on edition (American Psychiatric Association,
the whole family (e.g., Ahlström, Skäsäter, & 1994) into other diagnostic subtypes such
Danielson, 2009, 2010). as minor depression or dysthymia by signs
Depression is a rather vague descriptive and symptoms, onset, course, duration, and
term with a broad and varied meaning rang- outcomes.
ing from normal sadness and disappointment Family refers to any group that func-
to a severe incapacitating psychiatric illness. tions together to perform tasks related to
William Styron (1990) describes in Darkness survival, growth, safety, socialization, or
Visible the unsatisfactory descriptive nature health of the family. Family members can
of the term depression: “a noun with bland be related by marriage, birth, or adoption
tonality and lacking any magisterial presence, or can self- identify themselves as family.
used indifferently to describe the economic This definition is sufficiently broad to be
decline or rut in the ground, a true wimp of a inclusive of all types of families; however,
word for such a major illness” (p. 37). it is recommended that researchers provide
Depression is a universal mood state specific definitions of family appropriate to
with all people experiencing a lowered mood their research.
or transient feelings of sadness related to Genetic–biological research of depres-
negative life events such as loss. For most, the sion in families includes genetic and bio-
feelings of sadness or disappointment resolve logical marker studies (holmans et al., 2007;
with time and normal functioning resumes. Raison, Capuron, & Miller, 2006). The four
in contrast, the symptoms associated with the research approaches to the genetics of mood
psychiatric illness of depression can disrupt are as follows: (a) familial loading studies
normal functioning, influence mortality and (e.g., comparing families with depression
morbidity, and can cause a myriad of prob- to families without the disease), (b) stud-
lems within the family (hammen, Brennan, ies evaluating the inheritability of mood
& Shih, 2004; Katon, 2009; Katon, Lin, & disorders (e.g., twin studies), (c) studies of
Kroenke, 2007; Patten et al., 2008; Uebelacker incidence of the risk for but not yet ill from
et al., 2008). The psychiatric illness of major mood disorders to determine biological or
depressive disorder (MDD) is diagnosed psychological antecedents, and (d) in theory,