Reply to Letter to the Editor “Gold Versus Silver: The Issue of Functional Versus Symptomatic Recovery in Depression”

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Letter to the Editor

Sir: Dr. Pradhan provides thoughtful input regarding the appropriate threshold of treatment response to target for patients with affective and anxiety disorders. By reminding us that scoring low on a rating scale is not the same thing as being “well,” his comments underscore the need for clinicians to have different outcome targets (i.e., true recovery and well-being) than clinical investigators, whose studies target 50% or greater reduction of symptoms. After all, who would accept a 50% reduction of infectious organisms for an antibiotic or a 50% reduction of tumor cells in malignancies as appropriate outcome targets in these areas of medicine?

J Clin Psychiatry 2000;61(6):447-448