Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 5 years. No significant differences in the rate of graft failure were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 5 years after surgery.

First-episode patients have a high dropout rate. However, in compliant patients, the relapse rate was low, and therefore special attention and compliance-promoting interventions in first-episode patients are needed.

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Our training program was beneficial for primary care physicians' ability to recognize and manage depression. However, there was no significant decrease in local suicide rates.

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Sir: Wessely's review (1997) of books and reports on chronic fatigue syndrome (CFS) fails to mention the groundbreaking report of the independent National Task Force on CFS/PVFS/ME (Tyrrell, 1994). Before pro ducing its report, the Task Force (supported by the Department of Health) consulted widely, held a consensus meeting, and carefully considered the views of the patient organisations. Perhaps for these reasons, its report has escaped the severe criticism, mentioned by Wessely, that met the report of the Royal Medical Colleges (Anony mous, 1996). Wessely presents a picture of worthy psychiatrists motivated by the â€oe¿ desire for decision-making on the basis of evidence― compared with patients who, driven by emotion, often have â€oe¿ equal and opposite demands―. Patients may find this provoca tive and simplistic, particularly those who, despite the reports of the Task Force and of the Royal Medical Colleges, still find that they are not believed or listened to.