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.