BMJ 1996;312:512-513 (24 February)

Letters

Study had methodological limitations

EDITOR,--Christopher Dowrick and Iain Buchan report a trial to assess whether the outcome of depression is influenced by diagnosis by the general practitioner or by disclosure of the results of screening in cases of undetected depression.1 They conclude that disclosure did not improve prognosis at six and 12 months and that treatment of depression in primary care has little influence on the "course of a condition whose major determinants may lie outside the reach of the medical profession." We believe that this is an unnecessarily gloomy conclusion and reinforces a nihilistic attitude towards the treatment of depression and other psychiatric disorders that is commonly seen in primary care.

The authors did not consider important methodological limitations. The sample was small, so the possibility of a type II error was high. The analysis was not based on intention to treat, whereby all randomised subjects are included in the analysis and if . . . [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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