To the Editor: Dr Shelton and colleagues1 do not provide the actual data on which their conclusions
are based. The Hamilton depression (HAM-D) scores are presented only as unadjusted
group means. As HAM-D scores 20 and higher were required for trial entry,
the subgroup analysis of "less severely depressed" subjects (HAM-D score <
22) could only include subjects with a HAM-D score of 20 or 21. It is arbitrary
to designate an individual with a score of 21 as less severely depressed than
a score of 22. Similarly, the authors state that the mean (SD) duration of
current major depressive disorder was 2.3 (6.3) years in the treated group
and 2.7 (5.6) years in the placebo group. The SDs show that the distribution
is dramatically skewed, perhaps to an extent as to possibly affect the statistical
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