Distinguishing mental illness in primary care

摘要: Two studies in the BMJ last year make challenging reading set alongside one another. Kessler et al reported that over half patients attending general practice surgeries are depressed,1 and Norwegian naturalistic treatment study of depression concluded best for primary care is a combination antidepressant medication counselling.2 Read uncritically, these findings imply all should be taking antidepressants undergoing counselling. Clearly few people would agree with this, but apparent folly does draw attention to gap our understanding mental ill health care.3 Uncertainties about way provide such patients, indeed questions propriety doing so at within NHS, have long history. These uncertainties largely revolve around differences between medical sociological approaches psychological distress. The approach argues distress reflects an underlying illness which merits treatment. perspective it consequence failure respond adaptively social challenge. former focuses …