The Endogenous Depressive Pattern

UNCERTAIN diagnostic criteria and the lack of confirmatory evidence (such as known etiologies or specific treatments) contribute to current disillusionment with psychiatric classification, especially in American psychiatry. A revival of interest in psychiatric description of depressive illness has developed in recent years following advances in treatment and research techniques. In the late 1930's, electroconvulsive therapy was introduced as a partially effective somatic treatment for depression. More recently the monoamine oxidase inhibitors and the imipramine family of antidepressants have been added. The discovery of differential responses to these treatments has stimulated interest in clinical criteria which will enable one to make an optimal choice among them.1-3 These advances in therapy have been paralleled by an increasing sophistication in the laboratory study of neurochemicals. There has been special interest since 1959 in the role of norepinephrine and other catecholamines in depressive illness.4,5