Physicians’ Constructions of Depression: Inside/Outside the Boundaries of Medicalization

Abstract

A qualitative study explored primary care physicians' experiences of diagnosing and treating depression. Twenty physicians participated in semi-structured interviews. Interview questions asked physicians to consider a range of topics such as the etiology of depression, the diagnostic process and treatment of depression. Transcripts were analyzed discursively with a view to exploring the ways in which physicians construct depression. In this article, physicians' constructions of depression are examined through exploration of their descriptions of this condition, as well as their recognition of the social context of depression. Based on this analysis, it was concluded that physicians' medicalized understandings of depression conflict with recognition of the social context of depression. The result of this conflict is dissonant descriptions of depression. One implication of this research is that physicians' training would benefit from the integration of multidisciplinary perspectives on depression, which would better reflect physicians' experiences in routine practice situations.

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies

“…This finding is congruent with other commentaries on recognition and management of depression in UK general practice (34). Practitioners vary considerably in the threshold at which they will label patients as cases needing treatments because depressive symptoms are widely distributed through the population and change quickly (35).…”

Complexity of GPs' explanations about mental health problems: development, reliability, and validity of a measure

“…The scant previous research on GPs' ways of understanding mental health problems has been concerned with type of explanation; for example, whether doctors see common mental health problems as related to living or biomedical conditions, caused by psychosocial stresses or childhood experiences, or a function of patients' personalities. [11][12][13][14][15][16] By contrast, this complexity of psychosocial explanations measure is designed to be multi-theoretical such that a range of types of psychosocial explanation can be rated as complex, including lay explanations. 17,18 Complexity of thinking about mental health problems is likely to be partly a function of empathy, which is known to be important in general practice.…”

Psychiatrists' accounts of clinical significance in depression

“…Yet, very quickly he reverts to the language of medicine (cf. a report on doctors' medicalised accounts of depression Thomas-Mclean and Stoppard, 2004). The experience of being sad or perceptions of being sad give way to the occurrences of sleep disturbances etc.. What starts as an account of personalised experiences and perceptions quickly changes into depersonalised symptoms which simply occur, are had, rather than experienced or perceived.…”