November 4, 1983

Treatment of Depression-Reply

Author Affiliations

Riverdale, NY

JAMA. 1983;250(17):2286-2287. doi:10.1001/jama.1983.03340170024017

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In Reply.—  Dr Jones dissents not so much from the substance of my recommendation as from the fact that it was offered on the basis of clinical experience alone, without confirmation by extensive trials.Extensive systematic studies, in which observations are made and recorded by paramedical personnel, with or without questionnaires or rating devices, and the results of which are analyzed by statistical procedures, have become a shibboleth in modern phenomenological psychiatry.Extensive studies are demanded by academicians and institutionally based psychiatrists rather than clinicians in the private practice of psychiatry because the former see fewer patients on an intensive basis and are in a better position to conduct extensive studies. And since academicians edit most of the journals and select peer reviewers primarily from the ranks of academia, extensive studies are favored by psychiatric journals. Under the influence of these teachers, the younger generation of psychiatrists has come to