Treatment of Depression

Abstract

To the Editor.— In recent editorials, George Lundberg, MD, and E. H. Uhlenhuth, MD, both argue that the apparent undertreatment of major depressive illness in the community (reported by Keller et al) may not result from physicians' lack of knowledge but rather from a balanced consideration of the costs v benefits of antidepressant drugs (eg, side effects and suicide risk). There are data, however, that support the view that physicians may not possess adequate knowledge. Gottlieb et al 1 administered a written test of the diagnosis and treatment of anxiety and depression to 97 medical students, medical house staff, psychiatry residents, and faculty psychiatrists at Montefiore Hospital. While there were no differences among the groups in their performance on questions concerning the diagnosis and treatment of anxiety, medical students and medical house staff performed poorly (and substantially less well than psychiatrists) on questions concerning the diagnosis and drug treatment of