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April 1989

Intractable Atopic Eczema Suggests Major Affective Disorder: Poor Parenting is Secondary-Reply

Author Affiliations

1812 Delancey Pl Philadelphia, PA 19103

Arch Dermatol. 1989;125(4):568. doi:10.1001/archderm.1989.01670160116032

In Reply.—  Whereas we have no argument with Dr Allen as to the appropriate drug therapy for patients suffering from major affective disorders, it is clear that he is basing his thesis on a study of the literature, rather than the examination of particular patients, in his evaluation of our reported cases. Neither the mother in our target case, nor those of the other children cited, suffered from a major depressive disorder, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised.1More important, however, is that Dr Allen argues from an entirely different premise than do we; his theoretical position holds that adaptation and psychic change are best accomplished by chemical means through drug therapy. If we read him correctly, he is willing to set even infants on a life of therapy with antidepressant medications, if that be required to accomplish that end. We,