单选题 Family doctors routinely prescribe antidepressants to patients who may not need them, according to an exclusive survey for The Times. GPs are ignoring official guidelines by hastily prescribing pills rather than waiting to see if symptoms improve, the survey suggests. It also provides evidence that it is GPs and psychiatrists who are likely to propose medication as a treatment, rather than patients demanding pills to make them feel better. In addition, the findings raise questions about the efficacy of reviews of medication, required to make sure that patients are still receiving appropriate treatment. Some who took part in the survey claimed that their medication had not been reviewed for years. And there is evidence that GPs are reluctant to discuss options for ending medication, fuelling concerns that too many patients are condemned to take antidepressants for the rest of their lives regardless of improvements.
The survey, which was carried out by the mental health charity Mind, does contain positive news, however, with 84 percent of patients saying that their antidepressants were effective. Access to talking therapies appeared to be improving, and most patients said that they were able to taper off their medication without suffering harsh side-effects. Last week The Times revealed that more than one million men and women are addicted to benzodiazepine tranquillisers, drugs that include Valium and which should be prescribed for no more than four weeks for a severely restricted number of conditions.
The online survey proved to be one of the most popular ever held by Mind, attracting almost 1,500 responses from people who are on antidepressants or who have stopped taking them within the past two years. Paul Farmer, the charity"s chief executive, said: "Many people are being prescribed antidepressants too quickly and taking antidepressants for longer and longer periods without review. We must not demonise drugs and put people off taking something that might help them. But we need also to remember that antidepressants are powerful drugs and as such should be prescribed with caution."
More than 46 million prescriptions for antidepressants such as Seroxat and citalopram were written last year, a rise of 9 percent over the previous 12 months. Experts have expressed concern that doctors are prescribing drugs too casually, while GPs claim that patients expect to be given pills to help them through even relatively minor upsets. The Royal College of Psychiatry estimates that between 50 percent and 65 percent of people treated with an antidepressant for depression will benefit. Clare Gerada, a GP and president of the Royal College of General Practitioners, said: "I prescribe antidepressants because they work." The length of time people take antidepressants is a key issue. Of those who took part in our survey 37 percent had been on medication for more than five years and 20 percent for more than ten years.
Two thirds said that their GP or psychiatrist had prescribed antidepressants straight away rather than waiting to see if the symptoms improved as recommended in guidelines set by the National Institute for Health and Clinical Excellence (NICE). Four out of five said that it was their GP or psychiatrist who suggested medication in the first place. Of those, 51 percent said that they agreed that it was the right course of action but 42 percent were not in agreement. Forty-five percent of respondents felt that they were not given enough information about the medication they were prescribed, although this fell to 39 percent among those who were prescribed antidepressants more recently.
More than half said that they experienced ongoing side-effects. 27 percent said that antidepressants affected their ability to work or study; 24 percent their social lives; 21 percent their relationships with family, friends or partners; and 44 percent their sex lives. Only half of respondents have their drugs monitored every three months, and 72 percent at least every six months. Alarmingly, 6 percent never have their drugs monitored. A total of 25 people who took part in the survey had been taking drugs for more than five years without being monitored, and ten people for more than ten years.
GPs and psychiatrists appear reluctant to discuss coming off drugs with their patients: 71 percent said that they had not talked about discontinuing medication. Even those who had been on antidepressants for a significant amount of time had not had a discussion about coming off. More than a quarter said that they expected to be on antidepressants for life.
Only 7 percent of respondents who had come off medication within the past two years said this had been at the suggestion of their GP or psychiatrist. Since stopping medication 17 percent believed that they have recovered from their mental health problems, and 44 percent said that they could manage their mental health without drugs.
单选题 Of all the findings revealed by the exclusive survey for The Times, which one is NOT true?
【正确答案】 D
【答案解析】[解析] 对文章基本内容的理解。本文报道的是滥用抗抑郁药物的问题,选项A,B和C的说法均正确,可分别在文章第一、二、五段找到相应依据。选项D曲解了最后一段的内容。原句“Only 7 percent of respondents who had come off medication within the past two years said this had been at the suggestion of their GP or psychiatrist.”应理解为:所有在过去两年内减少了用药量的调查参与者中,仅有7%的人表示这是在其全科医生或精神科医生的指导下进行的。
单选题 The word "condemned" in the sentence "... too many patients are condemned to take antidepressants for the rest of their lives " (para. 1) can be paraphrased as ______.
【正确答案】 A
【答案解析】[解析] 根据上下文正确理解词语的能力。原句位于第一段末尾。由前文语境可知,在诊疗过程中,往往由医生主动提出药物治疗的方案,患者相对被动,加之医生不愿与患者商讨可替代药物的疗法,患者别无选择,只能终身服药。据此理解,选项A的forced意为“被迫……”,最为符合。condemn在本文中使用的是其转义,表示“迫使”。
单选题 What did Paul Farmer mean by saying "We must not demonise drugs and put people off taking something that might help them" (para. 3)?
【正确答案】 B
【答案解析】[解析] 根据上下文正确理解句子的能力。对demonise的理解是弄懂整句意思的关键。由demon(恶魔,魔鬼)派生而来的demonise意为“将……妖魔化”,即过分强调某事物消极、不好的一面,不对其加以客观审视。选项B的解释最为贴切。原句的前半部分并非在讲药物的疗效或安全性,选项A和D理解有误,应排除。选项C的意思违背文章的基本观点,也应排除。
单选题 More than half of the respondents of this online survey reported that they experienced ongoing side-effects, which affected all of the following aspects EXCEPT ______.
【正确答案】 D
【答案解析】[解析] 对文章基本内容的理解。具体内容见第六段。文中详细列举了调查参与者所遭受的各种副作用:①影响工作或学习能力,②影响社交活动,③影响与家人、朋友或伴侣的关系,④影响性生活。选项A,B,C均正确。至于药物对这些人的睡眠质量是否有影响,文中并未提及,故本题应选D。
单选题 What is the main idea of the passage?
【正确答案】 A
【答案解析】[解析] 对文章主旨大意的归纳能力。文章前两段集中说明了调查发现的核心问题,即医生不遵循官方指导,草率为患者使用抗抑郁药物。接下来进一步介绍调查取得的数据和信息,并借Paul Farmer之口表达了对这种情形的担忧。本文初衷显然是希望通过披露现实,进而改变这一令人担忧的状况,选项A与此相符。选项B于本文而言属细枝末节,文中一带而过,不能算作主旨。选项C的说法有违文章的基本意思。medication review只是此次调查反映出的问题之一,并不是最核心、最主要的,也应排除。