Drugs and Psychotherapy in Acute Depression-Reply

In Reply.—  —We agree with Dr Mattes that a combination of drugs and psychotherapy should not be given to all patients routinely. Notwithstanding the overall findings of the study (an additive and differential effect of drugs and psychotherapy) we do state that... there were major differences in the patients' acceptance of different treatments.... the patient who will not accept psychotherapy may be a good candidate for drugs alone, and vice versa. Patients who have marked vegetative complaints... might find the pharmacotherapy most useful. Patients in whom the emotional complaints and mood disturbance override the somatic ones might find psychotherapy more useful.^1.p1455Moreover, in a separate report, data are presented that give further guidance to the selection of treatments for individual patients. The data demonstrate the potential usefulness of the Research Diagnostic Criteria subtypes of depression as predictors of response to drugs and psychotherapy among depressive subtypes.²In any clinical