Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Williams and colleagues1 found that paroxetine was superior to psychotherapy
in treating dysthymia and minor depression among older patients in a primary
care setting. However, their study was seriously flawed in the choice and
administration of the psychotherapy component.
The patients who received psychotherapy were provided a previously
and untested protocol called problem-solving treatment–primary care
Although PST-PC is reportedly based on cognitive-behavioral principles,
the authors noted that the procedure is unpublished,
making it an unknown
that has not been peer reviewed. Furthermore, although the study used
psychotherapists from a variety of disciplines, these practitioners presumably
were not allowed to use more common psychotherapeutic interventions. Thus,
this was a test of PST-PC, not psychotherapy.
Freeny M. Treatment of Mild Depression in Elderly Patients. JAMA. 2000;284(23):2993-2994. doi:10.1001/jama.284.23.2993