From Ms L. Haygarth, MRPharmS
SIR,—I find very little that is understandable in "Onlooker's" note on understanding depression (PJ, January 8, p42).
There are two recognised standard classifications of depressive illness, neither of which include the terminology endogenous or reactive depression. One is in the International Classification of Disorders Chapter 10 (ICD10) and the other from the Diagnostic and Statistical Manual of Mental Disorder (DSMIV) from the American Psychiatric Association. Each of these helps depressive illness to be diagnosed by suitably trained individuals.
A suitable treatment option for depressive illness is, in most diagnosed cases, the use of an appropriate antidepressant for that individual, at an adequate therapeutic dose for an adequate period. It is important that this is accompanied by the appropriate support and supervision that ensures co-operation with, and response to, the treatment.
A patient diagnosed with a depressive illness with psychotic features may not necessarily be the best person to be advised to call out "walkies" to the dog.
Lynn Haygarth Ilkley, West Yorkshire