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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Which treatment can a PHS afford?
- Regina Stroebele (1 April 2001)
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The type of treatment matters less than ensuring it is done properly and followed up
- David Simpson (7 April 2001)
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Regina Stroebele, GP in Germany own praxis
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Professional or even just "small" talk about a patient`s problems is certainly effective in making him feel better. And counselling is a mostly important part of treatment also in somatic disorders. But counselling takes less time and (therefore) less money with a patient under antidepressants than with a patient that denies the need of being treated with drugs, because of additional psychotic symptoms, e.g. We should not leave the choice of the treatment strategy to the mentally sick. |
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David Simpson, Consultant psychiatrist Tavistock Clinic
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Managing depression in primary care The type of treatment matters less than ensuring it is done properly and followed up Editor- I am writing to express my concern and dismay that this editorial, which concludes that the type of treatment given to patients with depression 'matters less than ensuring it is done properly', obscures the very interesting discovery, of Chilvers et al published in the same edition, that not only does the type of treatment matter but that it matters specifically to those patients who choose counselling who appear to do better. This finding, which suggests that type of treatment does matter to patients and that giving those patients with a preference a choice, clearly has important clinical implications. This simple message is that patients with depression not only have views about their treatment but tend to prefer treatments which give them psychological understanding and when they get this it can help recovery. With this emphasis rather than that of the editorial which stresses the equivalent value of drug treatment for depression suggests that we really need to increase investment into the development of and research into psychological treatments for depression. The spin of the editorial obscures these important implications and restores the current position, which emphasises pharmacological treatments for mental ill health. It is of concern but no surprise that the investigators declare research funding by three major drug companies. Yours sincerely, Dr DAVID SIMPSON FRCP Edin FRCPsych
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