The analysis of the data reported by Tuma (Reference Tuma2000) is seriously flawed. In this report there are no primary outcome data for 26 (48%) of the elderly cohort and 8 (14%) of the younger adults. The eight elderly people developing dementia at the 4.5 years outcome point are included in the analysis of the outcome of depression but their depression outcome is not reported. Dementia is not the primary outcome in this study and, therefore, either subjects with dementia are excluded (as the author has done with natural deaths) or the depression outcome is reported. Presumably, they all survived or they would have been included as deaths.

This produces a serious bias and unfounded conclusions. For instance, if the eight subjects with dementia are excluded (as they must be if their depression outcome is not reported) then the elderly cohort at 4.5 years consists of 28 and not 36 subjects. Then, referring to Table 1, natural deaths removed, the outcome is lasting recovery 46% (not 36%), relapse and recovery 39% (not 30%), residual symptoms 7% (not 5.5%) and chronic 7% (not 5.5%). Of the elderly, 85% are recovered compared to 78% of younger adults.

If the eight dementia subjects were included and all had a lasting recovery from depression, or relapse with recovery, then the recovery rate is 88%. The conclusions reported for good outcome would be correct only if all eight subjects with dementia were included in the residual symptoms or chronic categories.

Of course, if all natural deaths had recovered from depression at the time of death, this would also paint a different picture. We all die but the issue here is whether we die happy or depressed.

It is critical that data are reported accurately. Misrepresentation of this sort could be extremely damaging.