BMJ  2005;331:158 (16 July), doi:10.1136/bmj.331.7509.158

Commentary

Why stop at antidepressants?

¹ Department of Psychological Medicine, University of Auckland, PB92019, Auckland 1, New Zealand s.hatcher@auckland.ac.nz

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

Two problems arise when assessing treatments for depression. The first is specific to depression and the second is inherent in using randomised controlled trials as the sole evidence for deciding questions about treatment. Moncrieff and Kirsch focus on drug treatments, yet most of these issues also apply to non-drug interventions.¹

Parker has described the problems of a "one size fits all" approach to trials of treatment for depression in which people with different severities of illness and symptoms are all included under the same heading of depression.² Ensuring participants remain blind to treatment is also a problem. Outcomes in depression trials are usually assessed with a rating scale. However, all rating scales are ordinal—someone who scores 20 on the Hamilton rating scale for depression is more depressed than someone who scores 10, but we can't say they are twice as depressed. Nevertheless, most researchers have assumed that you can, making . . . [Full text of this article]

Better evidence

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