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We thank Blackwell et al 1 for raising an important question about the classification of depression in a population of IBD patients in the UK. In our study,examining depression as a risk factor for the development of IBD,2 we chose to use a more restrictive case definition of depression based closely on a definition of major depressive disorder (MDD) as a clinically significant form of depression recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)3 and known to be associated with a significant degree of morbidity and mortality.4 5 In …
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