{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:05:48Z","timestamp":1777521948544,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,16]],"date-time":"2025-02-16T00:00:00Z","timestamp":1739664000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,2,16]],"date-time":"2025-02-16T00:00:00Z","timestamp":1739664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The study aimed to investigate how psychiatrists handle the diagnosis and treatment of depression in the adult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Psychiatrists (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200917) of the French-speaking Canton of Vaud (Switzerland), working in public institutions or in private sector (cabinets), having different theoretical backgrounds depending on their training (systemic, cognitive-behavioural or psychodynamic) and different duration of clinical experiences were included in the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A clinical vignette presenting a young man with depressive symptoms of moderate intensity having experienced multiples losses during the development and recent past was presented to the participants. Participants were invited to read the vignette and react (\u201cthinking aloud\u201d), followed by an invitation to elaborate on the diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A heterogeneous approach towards the diagnosis and treatment of depression was observed. Without a consensus regarding the diagnosis of depressions, two distinct ways to understand the clinical vignette emerged: one pathogenic, identifying the underlying causes of the depressive symptoms, and the other nosological, based on diagnostic criteria. Consequently, proposition for treatment also diverged ranging from psychotherapy, psychotropic medication, complementary and alternative treatments, and paramedical approaches such as ergo- and socio-therapy, at times leaving the choice up to the patient. Possible explanations for this diversity are a more or less strict adherence to diagnostic criteria used by the psychiatrists, be they ICD or DSM, the double training as psychiatrist and psychotherapist which is mandatory in Switzerland, a certain prudence regarding psychiatric diagnoses by fear of stigmatisation, attention to the therapeutic alliance or divergent views on the theoretical and conceptual understanding of depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this study underline the importance to include the epistemology of psychiatric disorders in training to raise awareness and conscientization regarding the influence of epistemological aspects on attitudes and approaches to the diagnosis and treatment of depression and other psychiatric disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437251317245","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:08:17Z","timestamp":1739750897000},"page":"320-327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Depressive Symptoms and Epistemological Approaches: A Qualitative Study Among Psychiatrists: Sympt\u00f4mes d\u00e9pressifs et approches \u00e9pist\u00e9mologiques : une \u00e9tude qualitative aupr\u00e8s de psychiatres"],"prefix":"10.1177","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5332-7479","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Piaux","sequence":"first","affiliation":[{"name":"Centre Hospitalier Universitaire Vaudois"},{"name":"Universit\u00e9 de Lausanne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9line","family":"Bourquin","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Vaudois"},{"name":"Universit\u00e9 de Lausanne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-7918","authenticated-orcid":false,"given":"Friedrich","family":"Stiefel","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Vaudois"},{"name":"Universit\u00e9 de Lausanne"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3917\/fp.004.0025"},{"key":"e_1_3_2_3_2","unstructured":"Principaux rep\u00e8res sur la d\u00e9pression https:\/\/www.who.int\/fr\/news-room\/fact-sheets\/detail\/depression (accessed 15 January 2020)."},{"key":"e_1_3_2_4_2","unstructured":"Overview | Depression in adults: treatment and management | Guidance | NICE https:\/\/www.nice.org.uk\/guidance\/ng222 (accessed 27 November 2022)."},{"key":"e_1_3_2_5_2","unstructured":"Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts. https:\/\/www.apa.org\/depression-guideline (accessed 27 November 2022)."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n1209"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3402\/qhw.v9.24866"},{"key":"e_1_3_2_8_2","unstructured":"Les repr\u00e9sentations sociales de la d\u00e9pression chez des m\u00e9dicins: Entre pratiques et normes | Papers on Social Representations http:\/\/psr.iscte-iul.pt\/index.php\/PSR\/article\/view\/217 (accessed 24 November 2019)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1981.01780340120017"},{"key":"e_1_3_2_10_2","unstructured":"Depression Treatments for Adults. https:\/\/www.apa.org\/depression-guideline\/adults (accessed 4 December 2022)."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.10.010"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","unstructured":"Bourgeois-Gu\u00e9rin V. 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