Aforementioned study analysis included published and previously unpublished data submitted to the FDA by the manufacturers of the four drugs. Kirsch et al concluded that "efficacy reaches clinical significance only in trials involving the most extremely depressed patients, and that this pattern is due to a decrease in the response to placebo rather than an increase in the response to medication." Researchers imply that less severe patients who take antidepressants probably shouldn't be on them. However, readers of the article may be draw completely different conclusions that these results indicate that the efficacy of antidepressants and placebos are equal. Kirsch at al did not include all possible data from studies completed subsequent to FDA submissions. Nevertheless, in line with many previous analyses, the meta-analysis demonstrates that antidepressants are significantly better than placebo. Besides the facturers associations of psychiatry like American Psychiatric Association and Psychiatric Association of Turkey representatives express "disappointment" at how the study was being reported by the media, suggesting that news reports may have caused unnecessary alarm and concern for patients. Depression is a very serious and chronic disorder and evidence show that it can have fatal consequences. Patients should consult with their doctors to come up with the treatment that is best for them.