Reply to Letter to the Editor "Gold Versus Silver: The Issue of Functional Versus Symptomatic Recovery in Depression"

Letter to the Editor

Sir: Dr. Pradhan provides thoughtful input regarding the appropriatethreshold of treatment response to target for patientswith affective and anxiety disorders. By reminding us that scoringlow on a rating scale is not the same thing as being "well,"his comments underscore the need for clinicians to have differentoutcome targets (i.e., true recovery and well-being) thanclinical investigators, whose studies target 50% or greater reductionof symptoms. After all, who would accept a 50% reductionof infectious organisms for an antibiotic or a 50% reductionof tumor cells in malignancies as appropriate outcome targets inthese areas of medicine?