Separation of anxiety and depressive disorders: Normal rules of critical evaluation were presumably suspended

doi:10.1136/bmj.327.7419.869-a

BMJ 2003;327:869 (11 October), doi:10.1136/bmj.327.7419.869-a

Letter

Separation of anxiety and depressive disorders

Normal rules of critical evaluation were presumably suspended

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

EDITOR—Shorter and Tyrer's conclusion that failure toadvance (drug) treatment of anxiety and depression is relatedto wrong (disease) classification seems to be based on severalfalse premises.¹

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Inverse relation between number of new drugs patented for mood and anxiety disorders and number of anxiety and depressive diagnoses in DSM revisions

Firstly, precise diagnosis is possible in mental disorders.

Secondly, drug licensing authorities require disease indicationsin standard (coded) diagnostic terms.

Thirdly, drugs are used only to treat disease (cause) not symptoms(effect).

Fourthly, drugs are the principal treatment agent in anxietyand depression.

Diagnosis in patients, particularly in mental illness, is simplya shortcut categorisation prompting further elucidation. Fullappraisal of patients in the context of their environment, beliefs,and many other factors is a more appropriate guide to therapeuticchoices, of which drug treatment is only one option.

The specification of product characteristics for the benzodiazepine. . . [Full text of this article]

Roger L Weeks, general practitioner

2 Deanhill Road, London SW14 7DF roger@safescript.org

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Relevant Article

Separation of anxiety and depressive disorders: blind alley in psychopharmacology and classification of disease: Edward Shorter and Peter Tyrer
BMJ 2003 327: 158-160. [Extract] [Full Text] [PDF]