Dr Rubin raises several methodologic and conceptual issues in his discussion of our study.1 He suggests that our conclusion that the validity of the Newcastle scale was supported more often than were the other sets of criteria may have been the result of methodologic artifact. Specifically, he notes that it was inappropriate to examine the relationship between the Newcastle scale and the presence or absence of DSM-III personality disorders because the Newcastle scale includes as a diagnostic criterion the item "adequate personality." We were aware of this potential confound and examined the relationship between an unconfounded Newcastle diagnosis and personality disorder diagnoses. As we indicated in the original article, we recomputed each patient's Newcastle score based on nine items, excluding the personality criterion. Using the same cutoff score as on the ten-item scale, only four patients without a personality disorder had their depression reclassified from endogenous to nonendogenous,
Zimmerman M, Coryell W, Pfohl B, Stangl D. Validation of Definitions of Endogenous Depression-Reply. Arch Gen Psychiatry. 1987;44(4):390–391. doi:10.1001/archpsyc.1987.01800160106013
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