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More Names for Depression: Is a Rose a Rose?-Reply

Robert M. A. Hirschfeld, MD
JAMA. 1997;278(12):982. doi:10.1001/jama.1997.03550120042030.
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In Reply.  —Dr Reynolds has come forward with a fascinating proposal—to rename clinical depression as "limbic dysfunction." His reasoning is that control or mediation of many of the symptoms of depression are located in limbic structures. His proposal is worthy of serious considerationI certainly agree that depression is a disorder of regulation, but I think it would be a mistake to reference this primarily to the limbic system. We have evidence that abnormalities in other areas of the brain (the frontal cortex and the caudate nucleus) are associated with depression.1-3 Furthermore, depression is a whole-body illness. For example, endocrinologic abnormalities are not restricted to the brain. Also, the proposal of limbic dysfunction ignores important cognitive (eg, feelings of worthlessness) and interpersonal (eg, social with-drawal and impaired relationships) features that are fundamental to depression.I would prefer to renew efforts at destigmatizing medical illnesses that have behavioral and emotional components


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