Short abstract
Psychiatrist who carried out important studies on postnatal depression and community care
In 1996 the BMJ organised an exhibition of photographs of leading British doctors at the National Portrait Gallery. The title of the exhibition, With Head and Heart and Hand, indicated that these were doctors who combined intellectual rigour, clinical skill, and compassion. Psychiatry was represented by Dennis Gath. The photograph showed him on a bridge in Oxford, appropriately symbolic of his achievements in linking psychiatry with the other specialties of medicine, and medicine with the other faculties of the university.
Dennis Gath joined the newly established Oxford University department of psychiatry in 1969, remaining there until his retirement in 1996. He carried out a systematic series of studies of the relationship between physical conditions and psychological disorders. At that time, most studies of this relationship had been inconclusive or misleading because of limitations of design and method. Dennis Gath introduced reliable methods of assessment and measurement, and an epidemiological framework, and thereby overturned many of the previous conclusions. He also carried out important studies of depression after childbirth, which showed it to be common and indicated how it should be treated.
With the growth of community care in the 1980s, Dennis Gath began a series of studies of its outcomes. The first concerned the treatment, in general practice, of minor mood disorders. Working closely with general practitioners he and his research team showed that many patients with these disorders recovered without medication. He showed that the others could be treated effectively with an uncomplicated form of counselling that he called problem solving; this could be provided effectively by general practitioners and practice nurses. These studies of the care of patients with less severe psychiatric disorders were complemented by studies of people with the most severe disorders, including homeless people with mental illness, and those receiving the care programme approach. These studies, like all his research, had practical outcomes.
Figure 1.
Credit: NICK SINCLAIR
This productive programme of research was only a part of Dennis Gath's contribution to Oxford psychiatry. He played a major part in developing teaching in psychiatry for medical students and training for postgraduates. As a co-author of the Oxford Textbook of Psychiatry, his wide knowledge and the exceptional clarity of his writing were major constituents of the book's success. He served on the medicine board of the university; he represented medicine on its general board; and he was chairman of the student health committee. Outside the university, the Medical Research Council, the Department of Health, the Royal College of Psychiatrists, and the US National Institute of Mental Health all sought his advice.
Dennis Hanson Gath was born in 1930. He entered Cambridge to read classics but changed to philosophy and psychology. After graduation, he decided to follow a growing conviction that his life should be in medicine, and he moved to Oxford for preclinical studies.
He initially thought of a career in hospital medicine, and obtained the MRCP. However, his growing interest in the personal side of medicine led him to psychiatry, and to the Maudsley Hospital.
At the Maudsley, Dennis Gath trained with Sir Aubrey Lewis, who insisted that his trainees should study the life and personality of each patient in the same fine detail as they studied the scientific basis of the illness and its treatment. It was an approach that fitted well with Dennis' background in science and the humanities, and one that guided all his subsequent practice and teaching. At the Maudsley he also learnt the techniques of epidemiological research, which were to inform his subsequent inquiries.
Dennis Gath was a sociable man. He enjoyed good company, good conversation, and good food and wine. He enjoyed music, the theatre, and long walks in the country-side, especially in France. He was an excellent companion, good natured, interesting, and interested in others. He was also a most generous and loyal friend.
In 1973 he was elected fellow of Wolfson College, and he enjoyed and played a full part in the intellectual and social life there. When he retired from his university post in 1996, he looked forward to a continuing involvement in college life and in the intellectual and cultural activities that abound in Oxford.
None of this was to be. The onset and relentless progression of Alzheimer's disease prevented Dennis from achieving his goals. He died from an intercurrent infection.
Divorced from his first wife, Anne Lewis, he leaves his second wife, Eileen Curl; three children; eight grandchildren; and two step-children and their five children.
Dennis Gath, clinical reader in psychiatry Oxford University (b 1930; q Oxford 1959; DM, FRCP, FRCPsych), d 14 May 2005.