Depressives, Doctors, and Antidepressants

Keller and colleagues, in their article in this issue ofThe Journal(see p 1848), assert that depression is undertreated and mistreated in the community. They suggest that the public and the medical profession are poorly informed about the treatments available for depression. They call for further research into the inappropriate behavior of patients and physicians, with a view toward providing corrective education for a prompt solution of this important public health problem. It is tempting to question the validity of the information available on the treatment of depression in the community by entering on a detailed critique of the methodological limitations of recent studies, particularly in the selection of samples and the identification of cases within these samples. Because the data of various flawed studies tend to converge, however, such criticism may be largely ritualistic. It is perhaps more useful here to consider some implications of the data. The