Depression in medical students.

To the Editor.— We have a problem with the report by Drs Clark and Zeldow 1 on the frequency and importance of depressed mood among medical students. What is depression? What is self-esteem? To clarify these constructs, specific measures are needed that unfortunately do not exist. Although we do not routinely use their measure of depressed mood (the Beck Depression Inventory), in the one study 2 (n = 140) where we did use it, we found that it was highly correlated with a measure of self-esteem ( r =.77). Furthermore, when items from both measures were combined and factor analyzed, the single dimension that emerged included six items from self-esteem and seven from the Beck Depression Inventory. There-fore, the Beck Depression Inventory results do not distinguish between depressed mood and self-esteem. But terminology is not the point of this letter. The model of medical students' self-concept that we have developed and use