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Steven Ferguson, MD
Hunter Hommes McGuire Hospital Veterans Administration Medical Center 1201 Broadneck Blvd Richmond, VA 23249

Arch Neurol. 1987;44(5):474-475.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The intuitive reasoning appears logical in the article by Reding et al.¹ It certainly seems plausible that increased motivation and participation may yield increased scores on the Barthel scale. However, conclusions reached in this article are not warranted by the available data. Both methodologic and interpretive problems exist. Furthermore, the absence of actual numbers of patients per category makes interpretation of the data difficult (for example, exactly how many patients had abnormal Zung depression scores and received placebo treatment, and how many of these reached target doses of medication or placebo?).

Merely adding averages given in Table 1 shows placebo groups had higher initial Barthel scale scores than treatment groups (45 vs 33), and especially in the abnormal dexamethasone suppression test (DST) results group (51 vs 22). Randomization of matched groups according to preliminary scores should have been used.

While the authors note that there was . . . [Full Text PDF of this Article]

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