To the Editor: I am concerned about the choice of the rating scales in the study of omega-3 augmentation of sertraline for patients with coronary heart disease (CHD) and depression by Dr Carney and colleagues.1 The main inclusion criterion regarding severity of depression was related to the Beck Depression Inventory (BDI) II self-rating scale. Patients with scores of 16 or greater were included. The Montgomery-Asperg depression rating scale may have been more specific for depression in CHD patients, since it takes into account psychological signs and symptoms more than the BDI-II and the Hamilton Rating Scale for Depression (HAM-D) 17 scale,2 which comprise more of the physical symptoms that can also occur in association with a somatic disorder like CHD.
Also, physically ill patients often respond well to antidepressant medication.3 Because of the potentially sufficient efficacy of sertraline as monotherapy, there might therefore have been a ceiling effect. This aspect of the study design could have contributed to the negative result of this study compared with 2 others that the authors cited.4 - 5 Investigating additional treatment with omega-3 in sertraline nonresponders could answer this question.
Financial Disclosures: Dr Anghelescu reported being an employee of Johnson & Johnson Experimental Medicine Neuroscience and having received honoraria from AstraZeneca, Janssen, Lilly, Pfizer, Sanofi-Aventis, and Schwabe.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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