Postscript

It is never an easy task to summarize a set of papers when each paper would deserve the 2,000 words that the discussants have available, and each contribution triggers thoughts and associations sufficient to match each of the papers in terms of length, even if not in terms of quality. David Taylor's instruction was to provide a “real discussion” which elaborates the findings presented, and brings together some of the common themes to emerge from the papers.

The first point to make about this collection of excellent contributions concerns the duality already identified by Taylor in his preface. There appear to be numerous dichotomies that still characterize the field as represented in these papers which indicate that coherent integration may be more aspirational than a realistic goal. The first of these is developmental: childhood and adolescent depression is treated and studied separately from its adult counterpart in most of these papers as elsewhere in the literature, yet we know the two to be different faces of the same coin (e.g. Dunn & Goodyer, 2006). The separation of this collection of papers into child and adult sections is inevitable given the current state of the literature but seems to us to mark a regrettable reluctance on the part of our community to adopt a socio-neuro-developmental view of the disorder – reluctance probably born more from the constraints of service organisation than the limitations of current scientific knowledge.

A similar regrettable dichotomy emerges from laboratory versus clinical encounter oriented papers. Rustin and Taylor do remarkable work in presenting to us the dilemmas facing the clinician confronted with adolescents and adults whose subjective experience can be so profoundly negative that death is a preferable alternative. The interiority of the clinical account is only partially met by the exteriority of the laboratory science. Even Murray's sensitive account of the babies of depressed mothers, or Hill's beautifully crafte