Guest Editorial

This issue of Psychoanalytic Psychotherapy, devoted solely to depressive disorders, puts the findings of neuroscience, behavioural genetics, developmental research, cognitive science, psychiatry and psychoanalytic approaches between the same two covers.

Readers of this journal might have a sense of why we choose to focus upon depression in this way. The significant health–economic burden associated with depression in the developed world has been increasingly recognized. The extension of evidence-based medicine into the mental health field has created a demand for evidence which has been largely sourced by turning to randomized controlled trials, predominantly of short-term cognitive therapies. However, many of us would argue that their findings have been over-estimated. The scoping criteria used by the National Institute for Clinical Excellence (NICE) adult depression guidelines rest on an assumption that ‘depression’ can be meaningfully separated out from the general category of common mental disorder (which used to be called mixed neurotic disorders). These criteria determined which studies were admitted and which not: most psychodynamic therapy studies were ruled out. In the UK, as we know, this set of factors was then used to argue for a major increase in the provision of short-term, predominantly cognitive, psychological therapies for the treatment of depression.

In truth, significant though the consequences of the resulting re-organization of the mental health provisions may prove to be, they are not the main reason for the interdisciplinary approach adopted for this issue. Rather, it is that scientific progress is making it unavoidable. Advances in neuroscience, genetics and developmental research have led to so many new findings that the theories offered by any isolated discipline are under strain. It is important to recollect that the coming paradigm shift applies as much to 19th, 20th and early 21st century models of psychiatry, or to the current theories o