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Authors' Response to Hogan 英文参考文献
Correspondence
Is It Just a Marker for Increased Care?
terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author
and source are credited.
Richard Hockey
Because of the nature of the analysis used in this study [1],
no conclusion is possible. There are plenty of examples in
the literature demonstrating the “ecological fallacy”. Studies
such as this have very little utility other than to generate
hypotheses. I tend to think that this association is a marker
for greater recognition and treatment for depression.
However, it’s a brave epidemiologist who would draw any
conclusions at all from an ecological association such as this
where the outcome is relatively rare.
Funding: The authors received no speci?c funding for this article.
Competing Interests: The author has declared that no competing interests exist.
DOI: 10.1371/journal.pmed.0030408
Authors’ Response to Hockey and Reidak
Because the increased prescriptions of antidepressants
are correlated to increased medical visits, it is tempting
to conclude, as Hockey did [1], that decreased suicides
are a function of greater recognition of depression. It
should be noted that the biggest cause of suicide is clinical
major depression and increased visits do not treat that;
antidepressants do.
In a comprehensive review of the literature on the role
of long-term antidepressant use to prevent relapse of major
depression, Geddes et al. [2] reported that “data were pooled
from 31 randomised trials (4410 participants). Continuing
treatment with antidepressants reduced the odds of relapse
by 70% (95% CI 62-78; 2p<0.00001) compared with treatment
discontinuation. The average rate of relapse on placebo was
41% compared with 18% on active treatment”. We therefore
conclude that just seeing a doctor is in the long term not
protective against major depression and its consequences,
such as suicide. The weight of existing data support
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