Meaningful Explanations vs Scientific Causality

To the Editor: To illustrate how meaningful explanations can obscure scientific causality, in their Commentary Drs Lyketsos and Chisolm¹ contrasted the explanations offered in the obituaries of the US author John Updike and the German billionaire Adolph Merckle. They noted that despite the “clear causal link between cigarette smoking and lung cancer,” Updike's obituary made no such causal connection, while in the face of the “lack of a direct causal link between stressful life circumstances and suicide,” Merckle's suicide was linked to his financial setbacks. The authors suggested that Merckle's death is better understood as due to depression as a “disease of the brain,” and that stressful life events, although meaningful, are not causal of suicide. They argued that the trap of meaning is one reason why depression, despite being the leading cause of disability in high-income countries, is so poorly recognized and treated.