Sunday, November 14, 2010

And we're back...Healthday tells us that social class affects your ability to get well if you have depression...

Please, someone hand me a frying pan to smack myself with. Maybe then I could lose enough brain cells to fail to notice the logic errors this wire service forces down our throats each day.

Here's the headline, 

Social Class May Affect Outcome of Depression Treatment

Really? How did Healthday get that from, 
Researchers reviewed the cases of 239 patients with major depression who took part in the U.S. National Institute of Mental Health Treatment of Depression Collaborative Research Program from 1982 to 1986.
The patients took antidepressants or received one of two different kinds of psychotherapy: interpersonal psychotherapy or cognitive-behavioral therapy. After treatment with drugs or psychotherapy, working-class and poor patients showed less improvement in their ability to function at work than did middle-class patients who had the same treatments, the University of Illinois researchers found.
1982-1986? Seriously. A meta analysis from OVER 20 years ago!!!  There were 3 groups. One group had antidepressants, one group had individual psychotherapy and 1 group had cbt.  Reminds me of "this little piggy, went to market...this little piggy stayed home."  Then, they tried to make conclusions about the efficacy based on the fact that "poor or working class" people having a different experience. Let's begin...
Sample size. How many of the patients were classified as "poor/working class" vs. "middle class"? Were they EQUALLY distributed in the three groups? What was the result for the "no treatment" control group ($20 says there wasn't one)? Each time you make the group smaller, it becomes harder to detect differences. Perhaps these things were addressed, Healthday doesn't tell us this, because Heathday seems not to respect our collective intelligence enough to do so.
Age of data.  Just so we're clear, antidepressant drugs have changed. Prozac and SSRIs came to market (there are those little piggies again) in 1987. Got that? A year AFTER the data were closed. The data may be irrelevant. Perhaps prozac would have worked wonders for both groups. Since those are the most prescribed class of antidepressants these days, it seems really silly to not have data about how patients do with that therapy. The title of the article would lead you to believe that drugs are less likely to help you when you're poor and depressed. Well, until someone adds the drugs we have today into the investigation, it's explanatory value remains limited at best.
Methods of treatment. No group had BOTH the drug and the psychotherapy. It is a well researched theory (NOTE I don't say FACT here because nothing in science can be "proven", even evolution remains a theory) that the most successful outcomes for depression patients come from a COMBINATION of psychotherapy and antidepressants.
Measurement of outcome. Success was considered "ability to function at work." Interesting. How the heck did they measure that? Supervisor interviews? Bonus payments? Performance appraisals? Attendance? Give me a break.
Oh and putting "may" in the title is a pathetic answer, so Healthday should give up the ghost and admit to writing for click through rates.
Please tell me what you think. Do you have a set of statistics driven journalism needing skewering? Let me know.

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