Algorithms: STAR*D, Positives, Negatives, and Implications for Clinical Practice

INTRODUCTION Major depressive disorder (MDD) is a highly prevalent mental illness that poses a hazard for the affected individuals, their respective family, and society at large. Results from multiple cross-national epidemiological studies indicate that the lifetime prevalence of MDD in Western societies is approximately 10% to 20% (1). MDD often pursues an episodic course without inter-episodic recovery; a bimodal age of onset is observed with peaks in early and mid-late adulthood. Individuals with MDD are differentially affected by both psychiatric (e.g., anxiety and substance use disorders) as well as disparate general medical conditions (e.g., cardiovascular disease, type II diabetes mellitus) (2).