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Monday, 11.12.2017

Comment (Samuel Gershon)

Dr. Katz’s career was completely contemporaneous with the introduction of imipramine into psychiatry and was actively involved with most aspects of studies in the area of depression and its treatment  and evaluation,. He was a primary player in the United States National Institute of Mental Health (NIMH) Collaborative Psychobiology of   Depression Program launched in 1970 and ran for 10 years.  He was involved in very many of the NIMH and United States Veterans Administration (VA) collaborative studies in these areas.  This background together with his own research on the clinical assessment concerns about the methods and the approaches used for the evaluation of change caused him considerable concern, He then undertook methods to develop new approaches that might present an evaluation of different facets of the clinical state. From his position he was perfectly situated to look at the data from all points of the compass, His conclusions offer the reader a very sobering picture of our current status of knowledge and he concludes we need to reevaluate our many positions and beliefs.  He quotes a Collegium Internatinale Neuro-Psychopharmacologicum (CINP) task force report "we still have found no biological ‘markers’ of the disorder nor are we completely clear as to mechanisms underlying their efficacy in depression" or their mode of action. He goes on to note the vast disparity in accumulated knowledge in genetics and neurosciences with the fact that no new compounds have been developed in the last 30 odd years. He feels that part of the problem may be in the central clinical problems in this area as well as the design and assessment aspects of the study He has spent many years of his own research in trying to address these questions. In conclusion the volume forces us to look at these discrepancies with these new approaches in mind,

Samuel Gershon
August 15, 2013