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Outcome of hospital-treated depression

Cardiff and District NHS Trust, Royal Hamadryad Hospital, Cardiff Bay, Cardiff CFII 6UQ

" ‘Then you should say what you mean’, the March Hare went on. ‘I do,’ Alice hastily replied ; ‘at least - I mean what I say-that's the same thing, you know.’ " (Lewis Carroll, Alice in Wonderland).

Tuma (2000) gives a ‘recovery’ rate of 24% for depressed elderly patients but this figure actually refers to his category ‘lasting recovery’. If the term recovery may be used to include those who have relapsed but then recovered for a (specified) period of time, the rate from Tuma's study is 44%, or 66% once natural deaths have been removed. Tuma appears to be following Murphy's (1987) view of recovery in depression as being a pint-pot only half-full.

This is not to disagree with the conclusion drawn from the study's data that elderly patients with depression have a poorer prognosis than younger adults, but there is a need to respond to the call for more clarity, if not unanimity, in what terms mean (Frank et al, 1991). Low detection and treatment rates for depression in older patients in the community are not likely to be improved by ‘term’-inally induced therapeutic nihilism. If we are to avoid such confusion, we should heed the words of another Lewis Carroll character :

" ‘When I use a word,’ Humpty Dumpty said in a rather scornful tone, ‘it means just what I choose it to mean - neither more nor less.’ "

REFERENCES

Frank, E., Prien, R. F., Jarrett, R. B., et al (1991) Conceptualisation and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851-855.[Abstract]

Murphy, E. (1987) The prognosis of depression in old age (letter). British Journal of Psychiatry, 150, 268.[Medline]

Tuma, T. A. (2000) Outcome of hospital-treated depression at 4.5 years. An elderly and a younger adult cohort compared. British Journal of Psychiatry, 176, 224-228.[Abstract/Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ridley-Siegert, D. Search for Related Content PubMed PubMed Citation Articles by Ridley-Siegert, D.