BMJ 1995;310:1267 (13 May)

Letters

Diagnosis of major depression is too broad

EDITOR,--Although depressive neurosis is equated with dysthymic disorder in the Diagnostic and Statistical Manual of Mental Disorders, owing to personal circumstances it can be severe enough to be equated with major depression. L M Mynors-Wallis and colleagues do not take this into account when measuring the efficacy of problem solving treatment in major depression in primary care.1

The implication of the finding that problem solving treatment is "effective, feasible, and acceptable" in patients with major depression is that this treatment is helpful to all such patients. What the authors have failed to examine is whether the subgroup of patients with environmental problems is more responsive than the subgroup with biological causes of their depression.

Locum consultant psychiatrist Mental Health Directorate (Inverclyde), Ravenscraig Hospital, Greenock PA16 9HA

J Watt 

  1. Mynors-Wallis LM, Gath DH, Lloyd-Thomas AR, Tomlinson D. Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in . . . [Full text of this article]


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