Snakebite Sociocultural Anthropological Bias 英文参考文献.docVIP

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Snakebite Sociocultural Anthropological Bias 英文参考文献.doc

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Snakebite Sociocultural Anthropological Bias 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; 2p0.00001) 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 supports