Khi một thành viên của một cặp vợ chồng phát triển trầm cảm hoặc lo lắng, điều này đã ảnh hưởng sâu sắc về mối quan hệ và các thành viên của các cặp vợ chồng có thể phát triển các mô hình tương tác và các hệ thống niềm tin rằng duy trì sự lo lắng hoặc trầm cảm. | Chapter 15 DEPRESSION AND ANXIETY When a member of a couple develops depression or anxiety this has a profound effect on the relationship and members of the couple may develop interaction patterns and belief systems that maintain the anxiety or depression. It is not surprising therefore that there is considerable evidence that couples-based treatments for depression and common anxiety disorders such as panic disorder with agoraphobia are particularly effective Beach 2002 Byrne Carr Clarke 2004a . A systemic model for conceptualising these types of problems and a systemic approach to therapy with these cases will be given in this chapter. A case example is given in Figure and three-column formulations of problems and exceptions are given in Figure . and . The lifetime prevalence of major depression is 10-25 for women and 5-12 for men American Psychiatric Association 2000 . Up to 15 of people with major depression commit suicide. The lifetime prevalence rates for all anxiety disorders is 10-14 and for panic disorder with or without agoraphobia the anxiety disorder considered in this chapter the rate is American Psychiatric Association 2000 . Many people attending psychiatric services show both anxiety and depressive symptoms and often a range of other problems such as substance abuse eating disorders and borderline personality disorder American Psychiatric Association 2000 . DEPRESSION Major depression is a recurrent episodic condition involving low mood selective attention to negative features of the environment a pessimistic belief-system self-defeating behaviour patterns particularly within intimate relationships and a disturbance of sleep and appetite. Loss is often the core theme linking these clinical features loss of an important relationship loss of some valued attribute such as health or loss of status for example through unemployment. In classification systems such as the DSM-IV-TR American Psychiatric Association 2000 and the ICD-10 .
