Letter

Problem solving treatment for depression

BMJ 2000; 320 doi: 10.1136/bmj.320.7245.1340/a (Published 13 May 2000)
Cite this as: BMJ 2000;320:1340.2

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Does the paper really prove that problem solving treatment is helpful?

  1. Charles West, general practitioner (gorswen@dircon.co.uk)
  1. Medical Centre, Church Stretton, Shropshire SY6 6BL
  2. Department of Psychiatry, Campbell Centre, Milton Keynes MK6 5NG
  3. Northern Health and Social Services Board, Ballymena, Northern Ireland BT42 1QB
  4. Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7BJ

    EDITOR—Please tell me if I am missing something, but I am not convinced that the paper by Mynors-Wallis et al shows that problem solving is an effective treatment for depression.1 As I read it, patients were allocated to one of four groups. Of the two groups treated with problem solving alone, up to a quarter (10 of 39 treated by the doctor and six of 41 treated by the nurse) withdrew from the trial because the treatment was not working. Those left in the trial—that is, those for whom the treatment was working—were compared with those given antidepressant treatment, and it was found that the treatment was working. I note that none of the antidepressant group withdrew because the treatment was not working.

    It may well be that problem solving is helpful for depressed patients. It may well be that an hour's initial treatment followed by up to six sessions of half an hour is helpful for depressed patients. But I am not convinced that this paper proves it.

    References

    1. 1.↵
      1. Mynors-Wallis LM,
      2. Gath DH,
      3. Day A,
      4. Baker F
      . Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for major depression in primary care. BMJ 2000; 320: 26–30. (1 January.)
      OpenUrlFREE Full Text

    Study should have included placebo group

    1. D Marchevsky, consultant psychiatrist (david.march@ukgateway.net),
    2. O Adebajo, senior house officer in psychiatry (david.march@ukgateway.net)
    1. Medical Centre, Church Stretton, Shropshire SY6 6BL
    2. Department of Psychiatry, Campbell Centre, Milton Keynes MK6 5NG
    3. Northern Health and Social Services Board, Ballymena, Northern Ireland BT42 1QB
    4. Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7BJ

      EDITOR—Mynors-Wallis et al conclude that problem solving is an effective treatment for depression.1 They base this statement on the effectiveness of selective serotonin …

      Access to the full text of this article requires a subscription or payment

      Subscribe

      Article access

      Article access for 1 day

      Purchase this article for £20 $30 €32*

      The PDF version can be downloaded as your personal record

      * Prices do not include VAT

      Rapid responses

      THIS WEEK'S POLL

      BMJ most popular