Almost every clinician that has treated patients with major depressive disorder (MDD) will boldly proclaim that depression is not a single illness with a common causative mechanism, pathophysiology, prognosis, or response to treatment. Yet, despite decades of effort, it has been nearly impossible to delineate subgroupings within the disorder, beyond major depression with psychotic features, that can reliably add greater clinical meaning to the general diagnosis subsumed under the rubric of MDD. The inability to achieve what would appear to be such a simple task has frustrated the field for generations.
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Sanacora G. Is This Where We Stand After Decades of Research to Develop More Personalized Treatments for Depression? JAMA Psychiatry. Published online February 19, 2020. doi:10.1001/jamapsychiatry.2019.4764
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