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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 improved millions 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
stems mainly 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 for depression 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. They describe 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 Berrios
offer 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 the future.
This book features nearly three hundred articles providing
practical information on how to care for elders. Written by more
than three hundred experts, this accessible state-of-the-art
resource addresses home care, including family-based care;
nursing-home care; rehabilitation; case management; social
services; assisted living; palliative care; and more. Each article
concludes with references to pertinent Web sites.
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