A 60-year-old Man with Major Depression

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<P>This 60-year-old man was referred by his psychotherapist whom he had been seeing twice a week for 12 years. He was in his fourth episode of non-psychotic major depression. He had no history of mania or hypomania. His first episode began at age 43. Each episode had an acute onset, reaching the nadir within 2 months of onset. He had full recovery between each episode. He was symptom-free in these inter-episode periods, during which function was normal. Each successive episode was longer and more severe than the prior one. It was difficult to pinpoint stressors that precluded the onset of each episode.</P> <H4>ABOUT THE AUTHOR</H4><P>A. John Rush, MD, is Vice Chair, Department of Clinical Sciences, and Professor, Department of Psychiatry, Betty Jo Hay Distinguished Chair in Mental Health, Rosewood Corporation Chair in Biomedical Science, University of Texas Southwestern Medical Center, Dallas, Texas.</P><P>Dr. Rush disclosed the following relevant financial relationships: Advanced Neuromodulation Systems, AstraZeneca; Best Practice Project Management, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Pharmaceuticals, Gerson Lehman Group, GlaxoSmithKline, Jazz Pharmaceuticals, Magellan Health Services, Merck, Neuronetics, Ono Pharmaceuticals, Organon Pharmaceuticals, Pamlab, Personality Disorder Research Crop., Pfizer, Urban Institute, and Wyeth: Consultant; Cyberonics, Forest Pharmaceuticals, and GlaxoSmithKline: Member of Speakers’ Bureau; National Institute of Mental Health, Robert Wood Johnson Foundation, and Stanley Medical Research Institute: Research Support; Guilford Publications and Healthcare Technology Systems: Royalties; and Pfizer: Stockholder.</P>