BMJ 1995;310:1266 (13 May)

Letters

Problem solving treatment for major depression in primary care

Problem solving treatment is time consuming

EDITOR,--Controlled evaluations of psychological treatments in general practice are greatly needed. Two important issues, however, are not discussed by L M Mynors-Wallis and colleagues in their evaluation of problem solving treatment in primary care.1

Firstly, their problem solving intervention is time consuming. Each patient in the problem solving group received an average of 214 minutes with either the general practitioner or a psychiatrist. This is relatively brief for mental health professionals, but such a commitment of time by general practitioners is impractical. Much more attenuated treatments will need to be developed before they will be taken up by general practitioners.

Secondly, the authors comment in their discussion that potentially suitable patients may not have been referred to the study because they were unwilling to take part in a trial with a randomised allocation to treatment. This is an extremely important point, about which no . . . [Full text of this article]


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Relevant Article

Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care
L M Mynors-Wallis, D H Gath, A R Lloyd-Thomas, and D Tomlinson
BMJ 1995 310: 441-445. [Abstract] [Full Text]

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