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Is It Just a Marker for Increased Care
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     Richard Hockey (rhockey@optusnet.com.au), Mater Hospital Brisbane, Australia

    Because of the nature of the analysis used in this study [1], no conclusion is possible. There are plenty of examples in the literature demonstrating the “ecological fallacy”. Studies such as this have very little utility other than to generate hypotheses. I tend to think that this association is a marker for greater recognition and treatment for depression. However, it’s a brave epidemiologist who would draw any conclusions at all from an ecological association such as this where the outcome is relatively rare.

    Reference

    Milane MS, Suchard MA, Wong ML, Licinio J (2006) Modeling of the temporal patterns of fluoxetine prescriptions and suicide rates in the United States. PLoS Med 3: e190–DOI: 10.1371/journal.pmed.0030190 DOI: 10.1371/journal.pmed.0030190.(Richard Hockey)