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Letters   |    
Psychopharmacology Plus Psychotherapy for Depression Treatment
Jürgen Unützer, M.D., M.P.H.; Wayne J. Katon, M.D.; Joan Russo, Ph.D.; Gregory Simon, M.D., M.P.H.; Michael Von Korff, D.Sc.; Elizabeth Lin, M.D., M.P.H.; Edward Walker, M.D.; Evette Ludman, Ph.D.; Terry Bush, Ph.D.
Psychiatric Services 2003; doi: 10.1176/appi.ps.54.7.1042-b

In Reply: We agree with Dr. Mark about the importance of the patient's perspective. However, we do not agree that our study focused "solely on pharmacotherapy." As we pointed out in the introduction, recent reviews of the evidence suggest that antidepressants and evidence-based psychotherapies are equally effective for major depression (1,2). The two studies in which we asked the willingness-to-pay questions tested collaborative care models for depression that included both pharmacologic and psychosocial treatment components (3,4). Our willingness-to-pay question did not focus solely on pharmacotherapy but asked study participants a "neutral" question about how much they would be willing to pay for a six-month course of depression treatment without implying that such treatment should involve pharmacotherapy or psychotherapy.

Depression Guidelines Panel: Depression in Primary Care: Clinical Practice Guideline 5. Pub no 93–0550. Rockville, Md, Agency for Health Care Policy and Research, 1993
 
Schulberg HC, Katon W, Simon GE, et al: Treating major depression in primary care practice: an update of the Agency for Health Care Policy and Research Practice Guidelines. Archives of General Psychiatry 55:1121–1127,  1998
[CrossRef] | [PubMed]
 
Katon WJ, Von Korff M, Lin EHB, et al: Stepped collaborative care for primary care patients with persistent symptoms of depression. Archives of General Psychiatry 56:1109–1115,  1999
[CrossRef] | [PubMed]
 
Katon WJ, Rutter C, Ludman E, et al: A randomized trial of relapse prevention of depression in primary care. Archives of General Psychiatry 56:1109–1115,  1999
[CrossRef] | [PubMed]
 
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References

Depression Guidelines Panel: Depression in Primary Care: Clinical Practice Guideline 5. Pub no 93–0550. Rockville, Md, Agency for Health Care Policy and Research, 1993
 
Schulberg HC, Katon W, Simon GE, et al: Treating major depression in primary care practice: an update of the Agency for Health Care Policy and Research Practice Guidelines. Archives of General Psychiatry 55:1121–1127,  1998
[CrossRef] | [PubMed]
 
Katon WJ, Von Korff M, Lin EHB, et al: Stepped collaborative care for primary care patients with persistent symptoms of depression. Archives of General Psychiatry 56:1109–1115,  1999
[CrossRef] | [PubMed]
 
Katon WJ, Rutter C, Ludman E, et al: A randomized trial of relapse prevention of depression in primary care. Archives of General Psychiatry 56:1109–1115,  1999
[CrossRef] | [PubMed]
 
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