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Talk:Talk-therapy can make a difference in early treatment of severe depression

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emailed the American Psychiatric Association <press at psych.org> for alternative viewpoint comment, chance to respond to claims in the Uni of Pennsylvania news release. - Simeon 04:55, 6 Apr 2005 (UTC)

Hi,

I am writing a news story for en.wikinews.org, an open news publishing web site, covering a recent report from a University of Pensylvania study.

In their press release, it is claimed:

http://www.upenn.edu/pennnews/article.php?id=777

"Cognitive therapy to treat moderate to severe depression works just as well as antidepressants, according to an authoritative report appearing today in the Archives of General Psychiatry. The study, conducted by researchers at the University of Pennsylvania and Vanderbilt University, challenges the American Psychiatric Association guidelines that antidepressant medications are the only effective treatment for moderately to severely depressed patients."

I wonder if the APA would like to comment in response to their statement, or to further points made in the press release?

Would you like to comment on the validity of the study?

Will the APA review its guidelines in reaction to this finding? or when might you do that?

Are medication and cognitive therapy mutually exclusive?

Does the study mean patients are better off not taking medication, and taking cognitive therapy instead? Or should both be used?

Is cognitive therapy the only such effective alternative/supplement to medication, or are other forms of therapy known to be effective?

Simeon Scott

I think your desire to email the other institutions is a good one. I also think that changing a story that another author created in anticipation of what the response might be is repugnant. I have changed the date of the story you wrote back to yesterday, since it is yesterday's news.

I have also flagged it, since it appears that you have treated the information in a very sloppy and personal POV fashion, rather than putting the real numbers, which you have termed on my talk page as "boring" on your POV story.

When you report, Simeon, report. Don't fabricate or use the documentation of a study as serious as this one to make debate points. Ultimately the reader is the one who loses, and you again seem to have no concept of and editor's responsibility to both the reader and other authors. I feel you have exceeded once again the ethics of the WIKI and the extended friendship and trust of others who, along with myself, were willing to overlook the last time you did this as a failure to communicate. It is not failure to communicate. It is simply wrong.

After you get a reply from your correspondence perhaps you can write a new story. For now, I believe my story should be reverted and what you have done amounts to educated vandalism. --HiFlyer 15:17, 6 Apr 2005 (UTC)

Alan, next time could you use less abuse, make fewer assumptions about my motives, and speaking of ethics of wiki, perhaps leave your ego at the door? - Simeon 15:21, 6 Apr 2005 (UTC)
I did not use the word "boring" on vs medication article|your talk page. Please do not make unfounded allegations like that in future. If you reread what I said, you may benefit. You are welcome to re-add the statistical information, but I advise you to put it at the end for the reasons I pointed out. - Simeon 15:34, 6 Apr 2005 (UTC)
Change "Boring" to "Confusing"

Yes...you said CONFUSING not BORING...The real numbers were Confusing...

"Your report contained quite a lot of the detail on the statistical methodology of the report, which most readers would just find confusing. If you ever really do want to include this type of detail, put it after a human-level explanation. I simply removed it in this case, because I think it was not enough detail to be useful to someone who would be interested in it, while being confusing enough to put off a reader uninterested in such details."

How did you make a judgement that our readers are too simple minded to want to know if there were 10,000 people or 60 in this test, Simeon? How confusing is that for you? --HiFlyer 16:01, 6 Apr 2005 (UTC)

The version of the article I left says there were 240 people in the study. Do you think most non-scientifically trained people would want to know more detail than that? Do you think most people who want more detail could not find the sources linked at the bottom of the article and click? - Simeon 16:10, 6 Apr 2005 (UTC)

Title

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Can you folks please agree on the title? Having to follow a trail of re-directs from the Main Page to find the article ain't great. Plus this story was put on the front page yesterday, please don't add it to more than one day. Dan100 (Talk) 15:41, 6 Apr 2005 (UTC)

Sorry, as explained above and in history commit comments, I missed the yesterday version, wrote a duplicate, and then merged the two. Someone has now removed the second entry from the front page. - Simeon 15:50, 6 Apr 2005 (UTC)
Regarding the title, I think Alan's titles underrate the significance of the finding. The idea that talking 'can make a difference' is not new. The finding of the study places cognitive therapy, on the balance, at about the same level of usefulness as medication, but for a longer-term result. This is clear from the title of their press release: Cognitive Therapy Works As Well As Antidepressants, But With Lasting Effect After Therapy Ends" (http://www.upenn.edu/pennnews/article.php?id=777).

'Misleading'

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Someone has tagged this story as being misleading. Could someone explain what the contentious points are so other editors could contribute? Dan100 (Talk) 15:47, 6 Apr 2005 (UTC)

I will create that paperwork in as short a time as possible, Dan. But let's start with the report's conclusion...the actual report, not Simeon's edition of it...
"In conclusion the report stated, “Cognitive therapy can be as effective as medications for the initial treatment of moderate to severe major depression, but this degree of effectiveness may depend on a high level of therapist experience or expertise.”"

It DID NOT STATE: One of the reports concluded that, "Cognitive therapy can be as effective as medications for the initial treatment of moderate to severe major depression, but this degree of effectiveness may depend on a high level of therapist experience or expertise." (Because there was ONLY ONE REPORT) What did the other reports say, Simeon? And where are they? Tell the truth...

Alan, linked at the bottom of versions of the article that I have lodged. You left out this,
Two articles based on the study were published in this month's April issue of Archives of General Psychiatry, a publication of The Journal of the American Medical Association.
Here are the two articles:

Simeon added: Researchers pointed out that while the effectiveness of cognitive therapy depended largely on the experience of the practitioner, the same was true of medication, due to the judgement required in prescribing correct dosages of drugs. Where did all the others say that, Simeon? Or are you postulating what they might have said if they were you? And did they say that about the INITIAL TREATMENT or the CONTINUED TREATMENT, Simeon, or do you know?

From the UPenn news release,
The researchers further believe that cognitive therapy patients might have done better at Penn due to the experience level of the therapists involved. Just as the experience of therapists may be important in cognitive therapy, so, too, can the expertise of prescribing physicians play a role in the success of antidepressant medication treatment. Studies have shown that antidepressant medication dosages are still largely a matter of physiciansdiscretion.
I'm not sure that it's important to emphasise a distinction between initial and ongoing here, but I suppose it wouldn't hurt. I mentioned that the study was 16 weeks. The word initial I picked up from your version and included already. Perhaps my text could be improved to Researchers believed that while the effectiveness of cognitive therapy depended largely on the experience of the practitioner, the same was true of medication, due to the judgement required in prescribing correct dosages of drugs. - Simeon 16:26, 6 Apr 2005 (UTC)

You see, Simeon, you did a bad thing and there is no justification

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Alan responds ::My report was about a :study. It reported on the results of the :study. You wish to add your own POV to what the :study said, then do it someplace else. This was a :study of initial treatment of moderate to severe depression. Understand? You are flying all over the place with no focus whatsoever trying to undermine the use of drugs. That is your perspective or, what we call, POV.That is not what the :STUDY was about, simeon. If you wanted to do a comparative report, or something from that angle, that is another story. But you were upset that I beat you to the punch so now we are playing these games. The story should be reverted and then you can write some comparative study and survey the studies. --HiFlyer 16:52, 6 Apr 2005 (UTC)
I request that the article be reverted immediately to my report of YESTERDAY and Simeon's report be put where ever he would like it other than over the top of mine. That seems fair but would still be misleading in its tone. --HiFlyer 16:15, 6 Apr 2005 (UTC)

OK...

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First up, can I just say that the above discussion is very hard to read? It's best if you can stick to plain text, and maybe italics if you're quoting. It's also very hard to see who was saying what (and so whom was making what point) - try and stick to linear replies, or if you must nest them be very clear with your formatting.

Second, if someone was 'first' to a story, it's very bad form just to over-write it with your own version. Editors really must take care to scan the Main Page and Developing stories to check if their story has already been covered. If it has, build on it. Usually there's only two things that can be wrong - orginal thinking (get a blog) or statements that aren't backed up by the linked sources (research it and try and get some sources, or take the dodgy statements out as a last resort). The other problem could be a lack of neutral point of view - if a story is very one sided, do some research and present the other side of the coin. Don't take out the points of view you found - counter them.

I have to be honest I'm finding it hard to find the nub of the issue you two are debating here. I'd say that you should definitely say that 240 patients were involved and that it's the largest study of this type yet. That's important background information. I'd then put across the results sticking as closely to the two reports of the trial as possible (but not copy-violating them or confusing readers.) Say that the initial treatment last 16 weeks and the follow-up two years. Say how CBT and drug therapies turned out. Mention that there were discrepencies between the two treatment centres involved (and give the reasons for that the researchers stated).

It's a very interesting story, it's a shame to see you guys fighting over it. Dan100 (Talk) 17:28, 6 Apr 2005 (UTC)

Well I went through the article myself and I couldn't see anything misleading, so I removed the tag. Dan100 (Talk) 17:35, 6 Apr 2005 (UTC)
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