Introduction

Our University School of Psychiatry has had a lengthy investment in the classification of depression, with the binary view favoured. The foundation professor, Leslie Kiloh, had undertaken a number of classic studies (e.g., Kiloh and Garside 1963) at Newcastle-on-Tyne, which made a strong argument that “endogenous” and “neurotic” depression are independent entities. After moving to Sydney, he designed a replication study (e.g., Kiloh et al. 1971), and follow-up of the cohort continues even now (e.g., Andrews et al. 1990a). The orientation of the dsm-iii classification (American Psychiatric Association 1980) to a more dimensional view of the affective disorders was of concern to us as we judged that the clinical and research utility in defining melancholia (or endogenous depression) risked being lost, and we sought to address that potential lost cause as our highest priority in setting initial objectives for our Mood Disorders Unit (MDU). Such indigenous concerns were later shared by North American researchers, with Zimmerman, Black and Coryell (1989) noting that the dsm-iii melancholia criteria had needed to be revised for two primary reasons: first, because the criteria “did not predict treatment response”; secondly, because “research suggested that the criteria did not identify a qualitatively distinct depressive subtype, but instead differentiated patients solely along a severity dimension.”