Christopher Dowrick - Böcker

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.

This book provides up-to-date, practical information for family doctors on how to assess and manage important mental health problems presenting in primary care settings. Patients frequently present with mental health problems in primary care settings around the world, yet family doctors consistently identify gaps in their knowledge, skills and confidence in how best to care for them. Contributors to the book are experts in primary mental health care and have consulted with family doctors around the world, to identify their main learning needs. Each of the nine core chapters will begin with a set of key points on ‘how to do it’ and will end with educational material in the form of clinical scenarios and multiple choice questions. This book describes core competencies for primary mental health care, clarifies how to conduct a first consultation about depression, reviews non-drug interventions for common mental health problems, discusses the management of unexplained physical symptoms, and advises on the physical health care of patients with severe mental illness. It explores the mental health needs of migrants and young people, and explains how to manage problems of frailty, multimorbidity and dementia. This book will be of interest to family doctors and students specialising in family medicine worldwide.

This book provides up-to-date, practical information for family doctors on how to assess and manage important mental health problems presenting in primary care settings. Patients frequently present with mental health problems in primary care settings around the world, yet family doctors consistently identify gaps in their knowledge, skills and confidence in how best to care for them. Contributors to the book are experts in primary mental health care and have consulted with family doctors around the world, to identify their main learning needs. Each of the nine core chapters will begin with a set of key points on ‘how to do it’ and will end with educational material in the form of clinical scenarios and multiple choice questions. This book describes core competencies for primary mental health care, clarifies how to conduct a first consultation about depression, reviews non-drug interventions for common mental health problems, discusses the management of unexplained physical symptoms, and advises on the physical health care of patients with severe mental illness. It explores the mental health needs of migrants and young people, and explains how to manage problems of frailty, multimorbidity and dementia. This book will be of interest to family doctors and students specialising in family medicine worldwide.

Primary care, grounded in the provision of continuous comprehensive person-centred care, is of paramount importance in the delivery of accessible and effective health care around the world. The central notion of person-centred care, however, relies on often-unexamined concepts of self, or understandings of what it means to be a person and an agent. This cutting-edge book explores contemporary pressures on the sense of self for both patient and health professional within a consultation and argues that building new concepts of the self is essential if we are to reinvigorate the central tenets of person-centred primary care.Contemporary trends such as shared decision-making between health professionals and patients and promoting self-management assume those involved are able to make their own decisions and take action. In practice, however, medicine often opts for reductionist perspectives of patients as passive mechanical systems and diseases as puzzles. At the same time, huge political and organisational changes mean time and resources are scarce, putting further pressure on consultations. This book discusses how we can start to resolve these tensions. The first part considers problems posed by the increasing bureaucratisation of primary care, the impact of information technology in the consultation, the effects of chronic disease on our sense of self and how an emphasis on biology over biography leads to over-diagnosis. The second part proposes solutions based on a strong ontology of consciousness, concepts of creative capacity, coherence and engagement, and will show how these can enhance the self-esteem of patients and doctors and benefit their therapeutic dialogue. Combining theoretical perspectives from philosophy, sociology and healthcare research with insights drawn from clinical practice, this edited volume is suitable for those researching and studying primary healthcare, communication and relationships in heal

Explores the ethical issues faced by GPs in their everyday practice, addressing two central themes; the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities.

Explores the ethical issues faced by GPs in their everyday practice, addressing two central themes; the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities.

This insightful and timely book equips family doctors and other primary healthcare professionals with the knowledge and skills needed to address a diverse range of new and important challenges in the field of primary mental health care, including ongoing impacts from the COVID pandemic, thanatophobia, and end-of life care, humanitarian and geopolitical catastrophes, and the effects of climate change.There is an emphasis throughout on the need to encourage and so reap the benefits of interdisciplinary collaboration between family doctors and mental health specialists, and across the range of primary care and community workers. Effective primary healthcare relies increasingly on the use of remote consultations, and the book explains how the potential of remote working can be maximized in low-resource settings. The book concludes with a consideration of how to protect and enhance the mental health of primary care workers in the face of these ongoing challenges in care.Key Features:Global and inclusive, providing practical guidance and direction across low-, middle-, and high-income settings, satisfying the needs of all primary care practitioners regardless of geographyFocused on key and immediate challenges for primary care practitioners arising from the COVID-19 pandemic, poverty, and social inequality, migration, and climate changeAddresses the vital importance of self-care by and of primary healthcare workers facing unprecedented work and emotional pressuresReflecting the expertise of the WONCA Working Party for Mental Health (WWPMH), building on the foundations laid in the 2020 WONCA volume Global Primary Mental Health Care, the editors and contributors all have expertise in primary mental health care at the frontline, with backgrounds in family medicine, psychiatry, psychology, and nursing.

This insightful and timely book equips family doctors and other primary healthcare professionals with the knowledge and skills needed to address a diverse range of new and important challenges in the field of primary mental health care, including ongoing impacts from the COVID pandemic, thanatophobia, and end-of life care, humanitarian and geopolitical catastrophes, and the effects of climate change.There is an emphasis throughout on the need to encourage and so reap the benefits of interdisciplinary collaboration between family doctors and mental health specialists, and across the range of primary care and community workers. Effective primary healthcare relies increasingly on the use of remote consultations, and the book explains how the potential of remote working can be maximized in low-resource settings. The book concludes with a consideration of how to protect and enhance the mental health of primary care workers in the face of these ongoing challenges in care.Key Features:Global and inclusive, providing practical guidance and direction across low-, middle-, and high-income settings, satisfying the needs of all primary care practitioners regardless of geographyFocused on key and immediate challenges for primary care practitioners arising from the COVID-19 pandemic, poverty, and social inequality, migration, and climate changeAddresses the vital importance of self-care by and of primary healthcare workers facing unprecedented work and emotional pressuresReflecting the expertise of the WONCA Working Party for Mental Health (WWPMH), building on the foundations laid in the 2020 WONCA volume Global Primary Mental Health Care, the editors and contributors all have expertise in primary mental health care at the frontline, with backgrounds in family medicine, psychiatry, psychology, and nursing.

Primary care, grounded in the provision of continuous comprehensive person-centred care, is of paramount importance in the delivery of accessible and effective health care around the world. The central notion of person-centred care, however, relies on often-unexamined concepts of self, or understandings of what it means to be a person and an agent. This cutting-edge book explores contemporary pressures on the sense of self for both patient and health professional within a consultation and argues that building new concepts of the self is essential if we are to reinvigorate the central tenets of person-centred primary care.Contemporary trends such as shared decision-making between health professionals and patients and promoting self-management assume those involved are able to make their own decisions and take action. In practice, however, medicine often opts for reductionist perspectives of patients as passive mechanical systems and diseases as puzzles. At the same time, huge political and organisational changes mean time and resources are scarce, putting further pressure on consultations. This book discusses how we can start to resolve these tensions. The first part considers problems posed by the increasing bureaucratisation of primary care, the impact of information technology in the consultation, the effects of chronic disease on our sense of self and how an emphasis on biology over biography leads to over-diagnosis. The second part proposes solutions based on a strong ontology of consciousness, concepts of creative capacity, coherence and engagement, and will show how these can enhance the self-esteem of patients and doctors and benefit their therapeutic dialogue. Combining theoretical perspectives from philosophy, sociology and healthcare research with insights drawn from clinical practice, this edited volume is suitable for those researching and studying primary healthcare, communication and relationships in healthcare and the medical humanities.

This book explores how literary reading can enable people considering suicide to stay alive. Written by an academic general practitioner with longstanding expertise in mental health, the book is grounded in the lived experience of patients, intertwined with perspectives from social psychology and moral philosophy. At its heart are reflective descriptions of the author’s encounters with Tolstoy’s Anna Karenina, and the Terrible Sonnets of Gerard Manley Hopkins, illuminating the therapeutic potential of recursive interactions between literature and experience.

This book explores how literary reading can enable people considering suicide to stay alive. Written by an academic general practitioner with longstanding expertise in mental health, the book is grounded in the lived experience of patients, intertwined with perspectives from social psychology and moral philosophy. At its heart are reflective descriptions of the author’s encounters with Tolstoy’s Anna Karenina, and the Terrible Sonnets of Gerard Manley Hopkins, illuminating the therapeutic potential of recursive interactions between literature and experience.