Antidepressants and counselling for major depression in primary care

doi:10.1136/bmj.323.7307.282

BMJ 2001;323:282 ( 4 August )

Letters

Antidepressants and counselling for major depression in primary care

Authors' conclusions were not justified by findings

Measuring preference in primary care studies could be improved

Counselling is not demonstrably as effective as drug treatment for depression

Authors' reply

Authors' conclusions were not justified by findings

The first 150 words of the full text of this article appear below.

EDITOR $---$ In their randomised trial of antidepressant drugs and generic counselling for treating depression, Chilvers et al concludedthat generic counselling is as effective as antidepressants andthat general practitioners should allow patients to have theirpreferred treatment.¹ Their findings do not, however, supporttheseconclusions.

The authors based their sample size calculation on a difference in mean Beck scores of 5 points as the outcome and found that44 patients in each arm were required for a power of 80%. Thissample size was not achieved in the randomised arms. They didnot calculate the sample sizes required for global outcome orremission, but they are likely to be much larger as these outcomevariables are categorical. Therefore, the only finding which achieveda power of 80% was related to Beck scores in the combined groupof randomised patients and patients expressingpreference.

Both general practitioner's rating and the score . . . [Full text of this article]

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Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms: Clair Chilvers, Michael Dewey, Katherine Fielding, Virginia Gretton, Paul Miller, Ben Palmer, David Weller, Richard Churchill, Idris Williams, Navjot Bedi, Conor Duggan, Alan Lee, and Glynn Harrison
BMJ 2001 322: 772. [Abstract] [Full Text] [PDF]