Beyond major depression

BACKGROUND: The DSM concept of 'major depression' has accrued increased status but demonstrated limited utility since inception. METHOD: An historical overview of models of depression and the initially perceived advantages presented by the concept of 'major depression' are presented before detailing its limitations in application. RESULTS: Challenges to the utility of 'major depression' are provided by examining its conceptual model, its validity, its utility and the limited information generated in aetiological and treatment efficacy studies. CONCLUSION: It is argued that the concept of 'major depression' has led to sterility in depression research and clinical practice, and that there is a need for a paradigm shift in modelling and classifying the depressive disorders.