[Major depression invites major concerns].

OBJECTIVE To overview limitations to the concept and construct of major depression. METHOD The objectives in initially conceptualizing major depression are examined against its subsequent utility and relevance to clinicians and researchers. RESULTS It is argued that, as defined, major depression does not differentiate clinical depression well from expressions of non-clinical depression or sadness, that its criteria set do not generate reliable diagnoses, that a diagnosis of major depression means little in and of itself (as it effectively comprises multiple types of depression) and that it fails to inform us about cause, natural history or differential treatment response. CONCLUSION Limitations to the concept of major depression would benefit from wider appreciation to advance changes to the clinical diagnosis of depressive sub-types.