Talking about depression: A corpus investigation of discourse presentation in interviews with general practitioners and psychiatrists

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Abstract

In Denmark, as in other countries, there is a declared intention to establish shared care between general practice and psychiatry for the increasing number of patients with depression. It has been suggested that the lack of shared care in the Danish health care system may be due to different understandings of depression in the two sectors. By applying a literary-stylistic framework designed to capture discourse (i.e. speech, writing and thought) presentation from a continuum of realisation options, I investigate how general practitioners and psychiatrists use presentations of own and others’ speech, writing and thought. The thesis has two main objectives: 1) to investigate how discourse presentation is employed in a corpus of institutional, non-narrative, spoken Danish and how discourse presentation within thiscontext compares to previous corpus studies of scalar discourse presentation; and 2) to investigate how the two groups of health care professionals employ discourse presentation as well as grammatical category features, and how these uses may be viewed as conceptualisations of depression. The quantitative results show several significant differences relative to previous corpus studies and between the two groups of health care professionals. In particular, the results for grammatical category features provide new evidence for uses of discourse presentation. Hence, I argue that these realisation patterns and associated uses indicate relatively sharp divisions in the health care system, in which the general practitioners conceptualise the doctor-patient relationship as symmetrical and themselves as critical towards and to some extent detached from the established system, but with minimal distance to ‘real life’. In contrast, the psychiatrists’ discourse presentation use indicates conceptualisations as specialists, with a larger degree of asymmetry in the doctor-patient relationship and a general tendency to express ownership of the treatment and the health care system. While most linguistic studies of health care communication focus on doctor-patient interactions, i.e. how medical professionals interact with patients, this study is a contribution to studying health care communication in a context of representation, i.e. how medical professionals talk about patients and illness. From an interdisciplinary perspective, the thesis offers a structural approach to uncovering conceptualisations in a context which, within the field of social medicine, is mostly examined from a thematic, phenomenological perspective.
OriginalsprogEngelsk
ForlagDet Humanistiske Fakultet, Københavns Universitet
Antal sider323
StatusUdgivet - maj 2019

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