Graphology: further study warranted

Unjustified tribute of graphology

To the Editor:Sir,I have recently come across the study byMouly et al. (1) published 2 years ago inClinical Practice. The authors aimed at eval-uating whether graphology (for a criticalappraisal on graphology see Beyerstein) (2)would help to differentiate letters written by40 people who committed suicide from let-ters written by 40 volunteers who acted ascontrols. To this end, the authors asked twopracticing graphologists and two registrarsnot trained in graphology to classify the 80letters as ‘suicide’ or ‘no suicide’. The resultsshowed that ‘both (i.e. graphologists andpeople not trained in graphology) classifiedthe letters with significantly more effective-ness than chance (p < 0.001) with no statis-tically significant difference between the two

groups of evaluators.’ Interestingly, thiswould mean that the letters themselvessomewhat carried the message, but thatbeing a graphologist and using graphologicalexpertise did not add to the ability to classthese letters. Yet, the authors concluded‘…that graphological analysis is able to dif-ferentiate letters written by patients whoattempt suicide from those written byhealthy controls’ (but so does any analysisperformed by anybody not trained in gra-phology, according to their own data). Iwould argue that the authors’ conclusionthat ‘this technique shows an acceptabledegree of accuracy and could thereforebecome an additional discharge or decision-making tool in Psychiatry or Internal Medi-cine.’ is little justified by the data they havereported.

S. Della SalaHuman Cognitive Neuroscience,

Psychology, Edinburgh, UKEmail: sergio@ed.ac.uk

References1 Mouly S, Mahe I, Champion K et al. Graphology for

the diagnosis of suicide attempts: a blind proof of

principle controlled study. Int J Clin Pract 2007; 61:

411–5.

2 Beyerstein BL. Graphology – a total write off. In:

Della Sala S, ed. Tall Tales About the Mind & Brain.

New York: Oxford University Press, 2007: 233–70.

Disclosure

No conflicts to declare.

doi: 10.1111/j.1742-1241.2009.02285.x

LETTER

Graphology: further study warranted

To the Editor:Sergio Della Salla accurately summarises ourstudy, but raises concerns about our conclu-sion on the use of graphology as a decisiontool for discharge after suicide. We agree thatthis conditional mood proposition does notfollow directly our results and is not evidencebased. But the decision of discharge after sui-cide is always difficult: patient’s allegations,psychiatric evaluation and clinical examination

have never been evaluated in term of predic-tive value for suicide relapse. Additional toolslike graphology might be studied to evaluatetheir ability to predict a relapse of suicide.This has not been conducted in our trial butmight be a study in the future. If graphologycould help to identify patients with highrisk of secondary suicide attempt, it mayincrease the safety of the critical dischargedecision.

J.-F. BergmannMedecine Interne A, Hopital Lariboisiere,

Paris, FranceEmail: jf.bergmann@lrb.aphp.fr

Disclosure

No conflict of interest related to this letter.

doi: 10.1111/j.1742-1241.2009.02293.x

LETTER

ª 2010 Blackwell Publishing Ltd Int J Clin Pract, April 2010, 64, 5, 661 661

Linked Comment: Bergmann. Int J Clin Pract 2010; 64: 661.

Linked Comment: Della Sala. Int J Clin Pract 2010; 64: 661.