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Let’s say a patient walks into my office and says he’s been feeling down for the past three weeks. A month ago, his fiancee left
Let’s say a patient walks into my office and says he’s been feeling down for the past three weeks. A month ago, his fiancee left
admin
2016-08-02
25
问题
Let’s say a patient walks into my office and says he’s been feeling down for the past three weeks. A month ago, his fiancee left him for another man, and he feels there’s no point in going on. He has not been sleeping well, his appetite is poor and he has lost interest in nearly all of his usual activities.
Should I give him a diagnosis of clinical depression? Or is my patient merely experiencing what the 14th-century monk Thomas a Kempis called "the proper sorrows of the soul"? The answer is more complicated than some critics of psychiatric diagnosis think. To these critics, psychiatry has medicalized normal sadness by failing to consider the social and emotional context in which people develop low mood for example, after losing a job or experiencing the breakup of an important relationship. This diagnostic failure, the argument goes, has created a bogus epidemic of increasing depression.
In their recent book " The Loss of Sadness"(Oxford, 2007), Allan V. Horwitz and Jerome C. Wakefield assert that for thousands of years, symptoms of sadness that were "with cause" were separated from those that were "without cause". Only the latter were viewed as mental disorders.
With the advent of modern diagnostic criteria, these authors argue, doctors were directed to ignore the context of the patient ’ s complaints and .focus only on symptoms—poor appetite, insomnia, low energy, hopelessness and so on. The current criteria for major depression, they say, largely fail to distinguish between "abnormal" reactions caused by "internal dysfunction" and "normal sadness" brought on by external circumstances. And they blame vested interests doctors, researchers, pharmaceutical companies for fostering this bloated concept of depression.
Yes, most psychiatrists would concede that in the space of a brief "managed care" appointment, it’ s very hard to understand much about the context of the patient’s depressive complaints. And yes, under such conditions, some doctors are tempted to write that prescription for Prozac or Zoloft and move on to the next patient.
But the vexing issue of when bereavement or sadness becomes a disorder, and how it should be treated, requires much more study. Most psychiatrists believe that undertreatment of severe depression is a more pressing problem than overtreatment of "normal sadness". Until solid research persuades me otherwise, I will most likely see people like my jilted patient as clinically depressed, not just "normally sad"—and I will provide him with whatever psychiatric treatment he needs to feel better.
The authors of the book " The Loss of Sadness " assert that the present criteria for major depression ______.
选项
A、can’t clearly tell mental disorders from normal sadness
B、encourage people to redefine the concept of depression
C、focus on symptoms of sadness without apparent causes
D、disregard the environmental context of depressed people
答案
A
解析
根据第五段中的“The current criteria…largely fail to distinguish between‘abnormal’reactions…and‘normal sadness’…”,A应为答案。
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0
考研英语一
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