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May 14, 1997

Underdiagnosis of Depression in Primary Care: By Accident or Design?-Reply

Author Affiliations

University of Texas Medical Branch Galveston

JAMA. 1997;277(18):1433. doi:10.1001/jama.1997.03540420029014

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In Reply.  —I wish that in our article we were able to state as poignantly and as articulately the points raised by Dr Bell. His years in the practice of medicine come through loud and clear from his comments.Bell's letter illustrates the continuing consequences of the stigmatization of depression and other psychiatric illnesses. Discrimination against those with depression, such as being rated or refused insurance, must be stopped. We must also strive to address the massive assault on confidentiality of medical records, including psychiatric records.Dr Berger describes the consequences of misinformation about and stigmatization of depression. He points out, in a very practical manner, that education and information can foster compliance with effective treatment recommendations. He suggests that we consider a change of term from "depression" to something that the public will identify as a medical disorder. It is a noble thought, but I doubt that it would be effective.