Psychological Problems in General Practice
A.C. Markus; C. Murray Parkes; P. Tomson; M.Johnston
Oxford University Press, 70 Wynford Dr, Don Mills, ON M3C IJ9
1989/406 pp

The authors believe that psychiatry in general practice is a different specialty from psychiatry in hospitals. The authors suggest that a problem-oriented model is more appropriate to family practice. The authors also believe that psychoanalysis is a frame of reference that has outlived its usefulness and have introduced their textbooks with chapters on ethology, psychology, and social science, as well as an introduction to the excellent British literature on the epidemiology of psychiatric illness in general practice.

The bulk of the book focuses on practical management by the primary care team, the family life cycle and its turning points, mind and body relationships, and traditional psychiatric disorders.

This book is well written, comprehensive, and for the most part, the authors have met their objective of providing information about the problems in family practice. I do have several reservations about the book, which perhaps reflect my bias of being a psychiatrist trained in North America and not a British family physician.

There is too much background information in the relatively lengthy book and not enough focus on the common clinical presentations of anxiety, depression, and substance abuse. The reference material is largely from the literature in England, and while I found that fascinating, I wondered whether some of the references and contents were relevant to North American practice.

Finally, the sections on counseling and individual psychotherapy, family and couple therapy, group therapy, etc, are well written, but they seem to expect more of a family physician than training and experience would suggest is reasonable. This book (no. 15 in the Oxford General Practice series) is a good example of newer models and practices for psychological problems in general practice and provides an introduction to literature not available in North American books. There are, however, shorter and more practical paperbacks available in the marketplace.

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