An end to depression in primary care?

摘要

I enjoyed Moscrop’s essay.1 As a GP Trainee in the early 70s with an interest in the psychological I was taught to distinguish between endogenous depression (no evident trigger, serious, chronic, more likely to respond to antidepressants) and reactive depression (for example, triggered by bereavement, relationship breakdown, or job loss, and less likely to respond to antidepressants). Inspired by the works of Michael Balint and Colin Murray Parks I tried to offer a listening ear to troubled patients in long appointments at the end of normal surgery times. There were inevitable disappointments, such as the newly-widowed lady who came to see me weekly over several months who plaintively asked on her last visit ‘So am I not getting any pills?’ An early addition to my Patient’s Unmet Needs list.