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December 20, 2000

Treatment of Mild Depression in Elderly Patients—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(23):2993-2994. doi:10.1001/jama.284.23.2993

In Reply: In response to Mr Freeny, PST-PC is a promising, behaviorally based, psychological treatment developed specifically for primary care. In 1 randomized trial, it was superior to placebo for major depression.1 In another trial, PST delivered by telephone showed clinically important effects.2 We built on previous studies by evaluating the effectiveness of PST-PC in patients with minor depression or dysthymia, using a relatively limited, but feasible dose for primary care (6 sessions). We agree that PST-PC is best categorized as a psychological treatment, not psychotherapy, and that the dose may have been too low for patients with dysthymia. In an ongoing study, we are evaluating the effect of more sessions of PST-PC. Until more definitive data are available, we consider it a psychological treatment in development.