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November 1984

Placebo-Control Groups in the Study of Outpatient Depressives-Reply

Author Affiliations

Psychiatric Outpatient Services Washington University School of Medicine 4940 Audubon Ave St Louis, MO 63110

Arch Gen Psychiatry. 1984;41(11):1110-1111. doi:10.1001/archpsyc.1983.01790220100017

In Reply.—  It is not clear to us why one of our treatment groups was an irrelevant standard for another. The groups were descriptively alike at the outset and responded very similarly, except for trivial mean differences at four weeks after treatment. (Remember that these were mean values.) Whatever is true of patients treated with TCAs in our study is equally true of those patients who were treated with cognitive therapy (CT), CT plus TCAs, and CT plus placebo. We have acknowledged that the lack of a placebo-control group limits the conclusions that can be drawn with respect to efficacy. One treatment was as good or bad as another of the four treatments tested in this population.With respect to the question of "placebo responders," we submit that Drs Quitkin and Stewart did not have the data to back their assertion. In one of their articles,1 they claimed to have found

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