Reinventing Depression: A History of the Treatment of Depression in Primary Care, 1940-2004

Hardcover | October 27, 2004

byChristopher M. Callahan, German E. Berrios

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To inform future research, treatment, and policy decisions, this book traces the scientific and social developments that shaped the current treatment model for depression in primary care over the past half century. While new strategies for diagnosing and treating depression have improvedmillions of people's lives, there is little evidence that the overall societal burden of depression has decreased. Most experts point to a gap between what psychiatrists know and what primary care doctors do to explain untreated depression. Callahan and Berrios argue, however, that the problem stemsmainly from lack of a public health perspective, that prevailing etiologic models underestimate the roles of society and culture in causing depression and over-emphasize biological factors. The current conceptual model for depression is a scientific and social invention of the last quarter century. Such models are important because they shape how society views people with emotional symptoms, defines who is sick, and determines who should get care. Most parents who seek treatment fordepression receive antidepressant medications in primary care. The authors show that although depressed patients' help-seeking behavior and primary care doctors' clinical approach have changed little over the past half century, the field of primary care medicine has changed dramatically. Theydescribe how the specific diagnoses and treatments developed by psychiatrists in the past 50 years have often collided with the non-specific approaches that dominate primary care practice. In examining the research seeking to close the gap between psychiatry and primary care, Callahan and Berriosoffer public health models to explain the ongoing societal burden of depression. By exploring the history of depression in primary care, they open a pathway for improvements in the care of people with depression, where primary care physicians should play a greater leadership role in thefuture.

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To inform future research, treatment, and policy decisions, this book traces the scientific and social developments that shaped the current treatment model for depression in primary care over the past half century. While new strategies for diagnosing and treating depression have improvedmillions of people's lives, there is little evide...

Christopher M. Callahan is at Indiana University Center for Aging Research. German E. Berrios is at University of Cambridge.
Format:HardcoverDimensions:240 pages, 6.1 × 9.21 × 0.79 inPublished:October 27, 2004Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195165233

ISBN - 13:9780195165234

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Table of Contents

Part I The Care of Emotional Disorders in Primary Care1. Why Depression?2. The Myth of the Old-Time Doctor3. The Myth of the Old-Time Patient4. A More Accurate Picture of Primary Care at Mid-Century5. Primary Care in CrisisPart II Origins of the Current Treatment Model for Depression6. From World War to Magic Bullets to Mass Strategy7. The Fall and Rise of Specialty Psychiatry8. "Perfect Drugs" for Primary Care9. The Birth of the Current Treatment Model10. From Helping the Doctor to Fixing the SystemPart III Lessons Learned and Moving Forward11. Boundaries and Limitations12. Dead Reckoning and Moving Forward

Editorial Reviews

"...Extremely thoughtful and impressive piece of work."--Medical History