Increasing Rates of Depression

To the Editor. —  It would have been appropriate if Drs Klerman and Weissman¹ had ended the title of their article "Increasing Rates of Depression" with a large question mark. They have presented data from their own work with colleagues or other researchers suggesting that the rates of depression, especially in the younger age groups, are increasing. Some of this work is on populations and some on selected patients and their first-degree relatives.Unlike studies in medical epidemiology, where diagnoses are made with standard laboratory tests or instruments with known sensitivities and specificities, psychiatric studies use self-reports, complaints, and symptoms as the bases for recording psychopathology. The specificity of these techniques is unknown or low. These techniques have introduced so much elasticity in the concept of depression that stuporous or severely melancholic patients as well as those complaining from unhappiness owing to adverse conditions or character defects are all