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 to advance (drug) treatment of anxiety and depression is related to wrong (disease) classification seems to be based on several false premises.¹

View larger version (21K): [in this window] [in a new window]   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 indications in standard (coded) diagnostic terms.

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

Fourthly, drugs are the principal treatment agent in anxiety and depression.

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

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

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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]