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The Importance of a Clinical Perspective

Richard M. Gottlieb, MD
Arch Gen Psychiatry. 1984;41(7):719-720. doi:10.1001/archpsyc.1984.01790180089011.
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To the Editor.—  It is important that investigators in psychiatry's basic sciences (eg, psychopharmacology and the brain sciences) have available a thorough familiarity with the clinical situation and with the body of accumulated knowledge derived from clinical work. When research studies are thus informed by clinical science, a high degree of clinical relevance and precision can be achieved. The report by Insel et al1 is illustrative of the kinds of shortcomings that can result when an investigation is not so informed.In their study of obsessive-compulsive disorder (OCD), Insel et al attempted to determine if clomipramine hydrochloride had a specific therapeutic effect. Particularly crucial was their attempt to separate clomipramine's known ability to relieve depressive disorders from any specific effect on the symptoms of OCD. The research design required that the active crossover drug in the placebo-controlled trial be pharmacologically different than clomipramine, but also have known antidepressant properties. An


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