Hyperthermia for Major Depressive Disorder?—Reply

In Reply We appreciate the insightful observations and questions raised by the letters from Fink and Shorter and Berk et al regarding our article.¹ Here, we respond to each letter in turn.

Fink and Shorter query whether whole-body hyperthermia (WBH) might have appreciable efficacy for major depressive disorder (MDD) with melancholic features. To enter our randomized trial of WBH, participants had to meet DSM-IV-TR–defined MDD and to have a 17-item Hamilton Depression Rating Scale score of 16or greater. Thus, we did not select for individuals with melancholia as defined by the DSM. Here, we provide 2 somewhat conflicting observations.