Letters

Treatment of postnatal depression

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7100.122 (Published 12 July 1997) Cite this as: BMJ 1997;315:122

Two weeks of depression may not be long enough to exclude spontaneous recovery

  1. Allan I F Scott, Consultant psychiatrista
  1. a Royal Edinburgh Hospital, Edinburgh EH10 5HF
  2. b 10 Upper Wimpole Street, London W1M 7TD
  3. c 9 Park Crescent, London N3 2NU

    Editor—In their study of the treatment of postnatal depression in primary care Louis Appleby and colleagues observed substantial improvement in patients' mood within one week.1 They raised the important question of how to distinguish transient distress from more severe types of depressive disorder and they suggested that the presence of depressive symptoms for at least two weeks identified what they called true depression.

    Findings from the Edinburgh primary care depression study suggest that this criterion may not be sufficient.2 Freeman and I studied patients with major depression—that is, dysphoric mood accompanied by at least four biological features of depression for at least two weeks.3 Randomised patients were interviewed by an independent rater immediately before they started treatment and within 72 hours of a diagnostic interview. Four patients satisfied the a priori …

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