2. 外语
  3. Although the stigma (污名) once associated with mental illness has receded in recent years, most of the 12 million Americans who h

Although the stigma (污名) once associated with mental illness has receded in recent years, most of the 12 million Americans who h

admin2012-05-28  105
问题     Although the stigma (污名) once associated with mental illness has receded in recent years, most of the 12 million Americans who have clinical depression still don’t get treated for it. In fact, according to mental health professionals, the majority of depressed people who seek professional help turn first not to a psychologist but to their primary-care physician.
    But do regular doctors really know how to identify depression? A large new scientific review published on July 30 by the journal Lancet suggests they don’t. In a review of 41 previous studies involving more than 50,000 patients in developed nations around the world, the authors found that general practitioners make frequent mistakes, missing true cases of depression about half the time and incorrectly diagnosing it in 19% of healthy people.
    This is significant because depression — especially if it goes untreated — can be debilitating (使衰弱) for the patient and his or her family. Depression also carries an enormous societal burden, leading to missed work days, loss of productivity and increases in health-care spending for co-occurring conditions like sleep problems or anxiety. Further, those misdiagnosed with depression may end up being prescribed antidepressant medications that not only cost a lot but can have serious side effects.
    The various studies used different methods to verify whether doctors had missed depression in their patients. All the studies pointed to the same conclusion: general physicians aren’t very good at recognizing the most common mental illness in the world.
    Why? One reason is that the typical doctor visit is quite short, usually no longer than 15 minutes. It’s hard for patients to open up about their symptoms during that brief period. The authors of the paper suggest that doctors should spend more time or schedule follow-up appointments with patients they suspect have depression and research has shown that such follow-ups can dramatically increase the rate of accurate diagnoses.
    That’s surely a worthy goal, although, at least in the U.S. , it offers a classic example of the incentive problems in the current health-care system: if general practitioners spend extra time with each patient trying to diagnose psychiatric problems, they will see fewer patients in a day, which means fewer reimbursements (返还的费用) overall from the insurance companies. So is there another way?
    Maybe. One method might be to write diagnostic criteria for depression that are sharper than the loose catalog of symptoms used today. The current Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association (APA), lists such vague symptoms as "fatigue" and "indecisiveness" as possible markers of depression. And while the definition must be broad enough to encompass (围绕) a disease that manifests in many different ways in many different patients.
    A large contingent (分遣队) of APA specialists is currently rewriting the diagnostic manual, but the revision won’t be out until at least 2012. In the meantime, most people will probably continue to use their general physician for front-line psychiatric care. That may be preferable to not seeking care at all, but for high-risk patients, it would be wiser to seek specialized attention.
Which of the following is held by the new scientific review in Lancet?
选项 A、There is no efficient medical care for clinical depression.
B、Developed countries are superior to developing countries in treating depression.
C、Depressed people in developed countries can turn to regular doctors.
D、The rate of regular doctors’ misdiagnoses in identifying depression is high.
答案D
解析 第二段指出<柳叶刀)上的一篇新科学评论认为普通医生并不真正知道如何诊断抑郁症。作者们回顾了以往的41项研究，这些研究涉及全世界发达国家的超过5万名患者，发现普通的心理医生经常出错，约一半的情况下没能查出真正的抑郁症患者，却将19％的健康人误诊为抑郁病患者。由此判断普通的心理医生诊断抑郁症时的误诊率还是很高的，故答案为[D]。
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