They only considered treatment with antidepressants indicated for current depression, ignoring possible continuation or maintenance treatment and other indications for the use of antidepressants like anxiety disorders. This is a rather limited definition, as continuation treatment is a well-established part of depression treatment and many antidepressants are also registered for anxiety disorders. Sihvo et al. described a group of 526 patients who used an antidepressant. They adopted a definition of overtreatment slightly broader than ours. Treatment was considered ‘‘nonpsychiatric’’ in case there was no CIDI diagnosis of MDD, Dysth,DCMU anxiety disorder, bipolar disorder or alcohol dependence in the last 12 months. The third previous study reported a small percentage of overtreatment in a Scottish primary care sample of 120 antidepressant users. They did not have a diagnosis based on a structured interview, but used a cutt-off score of the Hospital Anxiety and Depression Scale. It can be argued that our definition of non-justified antidepressant use is rather small, and that in reality more patients in our sample did not actually need an antidepressant. First, we defined lifelong treatment non-justified only for patients without a definite or possible justification. This created the problem of how to classify the category ‘possible justified’ for treatment beyond two years of patients with a recurrent depression,Thapsigargin while most guidelines recommend several years and only for a subgroup lifelong treatment. Second, also in case of anxiety disorders it could be argued that lifelong treatment is unnecessary in many if not most cases. Third, the diagnosis chronic MDD was based on the self-report of 24 months symptoms of depression in the past five years according to the life chart and a lifetime diagnosis of MDD. It could very well be that these patients had no chronic MDD, but just symptoms of depression during two or more years. This would mean that in more patients antidepressants would be unnecessary. When we would have classified all possible justified cases as overtreatment the percentage would indeed rise substantially: which is much higher and clearly illustrates the importance of a clear definition of overtreatment.