BMJ 1996;312:512 (24 February)

Letters

Patients may be receiving inadequate treatment

EDITOR,--Christopher Dowrick and Iain Buchan suggest that neither diagnosis nor disclosure of depression in general practice has an appreciable impact on outcome and that detection should be seen simply as a marker of severity.1 It is well recognised that there is appreciable unidentified psychiatric morbidity in primary care,2 and Dowrick and Buchan's paper reinforces this point. Two other findings that might have had an impact on outcome, however, are not highlighted. These are, firstly, adequacy of treatment and, secondly, non-attendance at follow up appointments.

It is a matter of some concern that the authors' data suggest that even when morbidity is conspicuous and an intention to treat exists, inadequate treatment is offered. This is particularly important if conspicuous morbidity has a worse prognosis in the long term.1

Unsurprisingly, a proportion of the subjects in the study subsequently failed to attend. It is interesting that this proportion varied across the three . . . [Full text of this article]


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Relevant Article

Twelve month outcome of depression in general practice: does detection or disclosure make a difference?
Christopher Dowrick and Iain Buchan
BMJ 1995 311: 1274-1276. [Abstract] [Full Text]

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