Depression: the evolution of modern paradigms and concepts.

We have presently three paradigms of depression: the psychoanalytic, the cognitive-behavioral, and the biological. The biological has so far produced the most effective treatment, but this theoretical structure is still the least cohesive; it is also less connected with its associated therapies than the two other paradigms. The search for unifying concepts and for indicators that may point to more specific therapeutic approaches to depression, goes on. It is an exciting search, but we must guard against the danger of losing contact between the rapidly progressing neurosciences and clinical research-the contact that should remain a precious "therapeutic alliance."