Introduction: Chronic Major Depression: A Review and Update

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Major depressive disorder has commonly been conceptualized as an episodic, recurrent condition. However, recent findings^1,2 indicate that a chronic course is far more common than originally believed. Further evidence^3,4 indicates that even if the major depressive episode "ends," meaning that symptoms are insufficient in number or pervasiveness to meet DSM-IV criteria for an episode of major depression, many patients still have "residual symptoms," which, in turn, are associated with poorer function and a worse prognosis^1,5 than are found in patients who attain a fully remitted or "asymptomatic" state.