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Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder
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To the Editor: Dr Wagner and colleagues1 concluded that "sertraline is an effective, safe, and well-tolerated short-term treatment for children and adolescents with MDD [major depressive disorder]." We have some questions about their methods.
First, the authors did not mention whether they assessed substance abuse or whether individuals with substance abuse were excluded from their study.
Second, although the authors stated that all investigators were required to pass a certification test for use of the Childrens' Depression Rating ScaleRevised (CDRS-R), it is unclear whether their interrater reliability was assessed.
Third, the authors excluded some randomized patients from their analyses. According to the principle of intention to treat (ITT), the authors could have assigned the "worst-case outcome" to the excluded patients.
Finally, more detailed tables would have been useful. The authors used P values to assess statistical significance. While this is at times useful, it is an arbitary value and the . . . [Full Text of this Article]
Maju Mathews, MD, MRCPsych, Dip Psych
Department of Psychiatry Drexel University College of Medicine Philadelpia, Pa
Manu Mathews, MD
Department of Psychiatry East Surrey Hospital Redhill, England
Joanne Mathews, MD
Department of Psychiatry West Suffolk Hospital Burys St Edmonds, England
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