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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.
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.
The type of treatment matters less than ensuring it is done properly and followed up
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
Consultant psychiatrist
Tavistock Clinic,
London NW5 per
Competing interests: No competing interests