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September 1983

Postpsychotic Depression

Arch Gen Psychiatry. 1983;40(9):1036. doi:10.1001/archpsyc.1983.01790080118022

To the Editor.—  In "Development and Prediction of Postpsychotic Depression in Neuroleptic-Treated Schizophrenics," (Archives 1982;39:197203), Mandel et al stated, "A score 16 or greater on the HDS [Hamilton Depression Scale] total score, a global measure, was used as the 'definition' of depression." I wish to point out two methodologic issues in this investigation. First, the very use of the HDS on patients with diagnoses other than affective disorder of depressive type departs from the original recommendation of Max Hamilton, who stated "The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type."1 Evidently, the sample of the study by Mandel et al did not have the diagnostic characteristics indicated by Hamilton. Second, the HDS was devised to measure the change in depressive psychopathology and not to "define" or identify the nature of psychopathology. Perhaps, owing to these methodologic pitfalls,

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