Hostname: page-component-7d684dbfc8-csfzr Total loading time: 0 Render date: 2023-09-24T17:19:18.490Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "coreDisableSocialShare": false, "coreDisableEcommerceForArticlePurchase": false, "coreDisableEcommerceForBookPurchase": false, "coreDisableEcommerceForElementPurchase": false, "coreUseNewShare": true, "useRatesEcommerce": true } hasContentIssue false

Is Your ‘Double-Blind’ Design Truly Double-Blind?

Published online by Cambridge University Press:  02 January 2018

Alison Oxtoby*
Whiston Hospital, Warrington Road, Prescot, Merseyside
Angela Jones
St Helens & Knowsley, District Health Authority, Tower Hill Health Centre, Moorfield, Tower Hill, Kirkby, Liverpool
Michael Robinson
Southport General Infirmary, Occupational Therapy, Day Hospital, Curzon Road, Southport, Merseyside PR9 0LT


Before a drug trial, researchers reasonably plan that participants will remain ignorant of which drug each patient is taking, reflected in the use of allegedly identical preparations. However, only rarely is this plan subjected to systematic scrutiny after the event, and our point of view is that this is unsatisfactory.

Point of View
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


A full bibliography is available on-request.


Baastrup, P. C., Poulsen, J. C., Schou, M., et al (1970) Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet, ii, 326330.CrossRefGoogle ScholarPubMed
Brownell, K. D. & Stunkard, A. J. (1982) The double-blind in danger. Untoward consequences of informed consent. American Journal of Psychiatry, 139, 14871489.Google ScholarPubMed
Byington, R. P., Curb, J. D. & Matron, M. E. (1985) Assessment of double-blindness at the conclusion of the β-blocker heart attack trial. Journal of the American Medical Association, 253, 17331736.CrossRefGoogle ScholarPubMed
Coppen, A., Noguera, R., Bailey, J., et al (1971) Prophylactic lithium in affective disorders. Lancet, ii, 275279.CrossRefGoogle ScholarPubMed
Dickson, W. E. & Kendell, R. E. (1986) Does maintenance lithium therapy prevent recurrences of mania under ordinary clinical conditions? Psychological Medicine, 16, 521530.CrossRefGoogle ScholarPubMed
Hill, L. E., Nunn, A. J. & Fox, W. (1976) Matching quality of agents employed in “double-blind” controlled clinical trials. Lancet, i, 352356.CrossRefGoogle ScholarPubMed
Howard, J., Whittemore, A., Hoover, J. J., et al (1982) The aspirin myocardial infarction study research group. How blind was the patient blind in AMIS? Clinical Pharmacology and Therapeutics, 32, 543553.CrossRefGoogle Scholar
Letemendia, F. J. J. & Harris, A. D. (1959) The influence of side-effects on the reporting of symptoms. Psychopharmacologia, 1, 3947.CrossRefGoogle Scholar
Leyburn, P. (1967) A critical look at antidepressant drug trials. Lancet, ii, 11351138.CrossRefGoogle Scholar
Marini, J. L., Sheard, M. H., Bridges, C. I., et al (1976) An evaluation of the double-blind design in a study comparing lithium carbonate with placebo. Acta Psychiatrica Scandinavica, 53, 343354.CrossRefGoogle Scholar
Mawson, D., Marks, I. M. & Ramm, L. (1982) Clomipramine and exposure for chronic obsessive-compulsive rituals. British Journal of Psychiatry, 140, 1118.CrossRefGoogle ScholarPubMed
Prien, R. F., Klett, C. J. & Caffey, E. M. Jr (1973) Lithium carbonate and imipramine in prevention of affective episodes. Archives of General Psychiatry, 29, 420425.CrossRefGoogle ScholarPubMed
Prien, R. F., Kupfer, D. J., Mansky, P. A., et al (1984) Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Archives of General Psychiatry, 41, 10961104.CrossRefGoogle ScholarPubMed
Rickels, K., Lipman, R. S., Fisher, S., et al (1969) Is a double-blind clinical trial really double-blind? Psychopharmacologia (Berlin), 16, 329336.CrossRefGoogle ScholarPubMed
Robinson, M. L. (1985) MRC trial of treatment of mild hypertension (letter). British Medical Journal, 291, 347.CrossRefGoogle Scholar
Sussex Clinical Trials Group (1985) Separate and combined anxiolytic and antidepressant treatment of mixed anxiety/depression. Acta Psychiatrica Scandinavica, 72, 8188.CrossRefGoogle ScholarPubMed
Zifferblatt, S. M. & Wilbur, C. S. (1978) A psychological perspective for double-blind trials. Clinical Pharmacology and Therapeutics, 23, 110.CrossRefGoogle ScholarPubMed
Submit a response


No eLetters have been published for this article.