Beyond Depression: A New Approach to Understanding and Management

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OUP Oxford, Jul 9, 2009 - Medical - 242 pages
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Is there an epidemic of depression sweeping the world, or are we radically altering our interpretation of normal human experiences? Do we need a dose of medication or a renewed sense of meaning? In this second edition of Beyond Depression, Christopher Dowrick - an academic general practitioner - takes a critical insider's look at commonly held views about the diagnosis and management of depression. He argues that our belief in depression as a medical condition is based on commercial, professional, organisational and cultural factors which combine to sustain the popularity of depression as a concept, which is based more on our values than on science. Based on the best contemporary evidence available, this second edition includes new research findings on the management of mild and recurrent depression, the possibility of a genetic basis to depression, and extended arguments on the limitations of screening, and the placebo effects of antidepressant medication. The author considers alternative ways of understanding the thoughts and feelings that we currently describe as depression, drawing on cross-cultural, religious, political and literary sources. He proposes a conceptual framework that provides a means of moving beyond depression as a medical concept and as a personal problem. When applied to encounters between doctors and patients in primary care it leads us towards enabling narratives, with an emphasis on listening and understanding rather than diagnosis and prescription. Beyond Depression combines a comprehensive analysis of current scientific evidence with an impressive review of linguistic, literary and philosophical perspectives. Moving seamlessly between controlled trials and Camus, from prescribing to Proust, the book is informed throughout by a series of sensitive case studies drawn from the author's personal experience.
 

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Contents

1 Points of departure
1
2 Depression as a medical condition
15
3 Disputed diagnoses
61
4 Drivers to diagnosis
101
5 Broadening the mind
129
6 Coherence and engagement
159
7 Encounters in primary care
199
Index
237
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About the author (2009)


Christopher Dowrick is Professor of Primary Medical Care in the University of Liverpool, and a general practitioner with the Aintree Park Group Practice. He is a Senior Investigator with the National Institute for Health Research in England, and a Professorial Fellow with the University of Melbourne, Australia. He is editor of the international journal Chronic Illness. His research expertise is in the field of primary care mental health, with a portfolio of grants and over 100 publications on depression and medically unexplained symptoms. He leads a major NIHR R&D programme (2007 to 2012), designed to increase equity of access to high quality mental health services in primary care.

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