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Research

Functional outcomes of multi-condition collaborative care and successful ageing: results of randomised trial

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6612 (Published 10 November 2011) Cite this as: BMJ 2011;343:d6612

Rapid Response:

Re: Functional outcomes of multi-condition collaborative care and successful ageing: results of randomised trial

The prevalence of chronic physical illness and depression is well known. However, the method of diagnosis, severity scoring of depression and whether the treatment of co-morbid depression requires only talking therapies (Counselling, Cognitive Behavioural Therapy and Improving Access to Psychological Therapy services) is unclear. The stigma of mental illness prevents patients from volunteering the information on mental state but enhances the likelihood of emphasising the physical symptoms. The incidence of depression is very high (about 75%) among Chronic pain sufferers.

It is time clinicians and commissioners consider optimal management of co-morbid depression and methods to achieve improvement of depression which if unaddressed, adversely affect the outcomes of all physical chronic diseases.

At the time of financial constraints in the NHS ignoring this fact and promoting talking therapies alone as panacea to all emotional ills are only likely to lead to long term morbidity in the population.

Who should start the collaboration? Surely the mind body dualism of 18th century should be a thing of the past.

Competing interests: No competing interests

26 November 2011
Gnanie Panch
Pain specialist
whittington trust
17 Bulmer Gardens