The changing epidemiology of depression.

At the clinical level, we have seen the emergence of a subspecialty of affective disorders within psychiatry. Mood clinics, depression units, and affective disorders centers are appearing in many academic and clinical settings, where clinical skill and knowledge can be concentrated and new research furthered. By using structured interviews and the newer diagnostic systems, systematic evaluation of patients has contributed to improved care. Greater skill in psychopharmacology and in specialized psychotherapeutic techniques has resulted in reduction of hospitalization and rates for depression, shortened duration of illness, and, in some instances, reports of reduction in suicide attempts and suicide deaths.