Special clinics are inappropriate for treating depression

doi:10.1136/bmj.321.7254.178

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Richard Churchill, lecturer in general practice (dick.churchill@nottingham.ac.uk),
Lionel Jacobson, honorary lecturer

Division of General Practice, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH
Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Cardiff CF23 9PN

EDITOR—Kendrick proposes introducing special clinics for the management of depression in general practice because depression is a chronic remitting condition.1 He draws analogies with other chronic conditions such as diabetes and asthma, where care is often provided in clinics devoted to the management of the specific condition. His argument is flawed on several counts.

Firstly, diabetes and asthma are relatively homogeneous physical illnesses for which there are acceptable treatments, objective measures of control, defined management targets, and some knowledge …