Background. The DSM concept of ‘major depression’ has accrued increased status but demonstrated limited utility since inception.

Method. An historical overview of models of depression and the initially perceived advantages presented by the concept of ‘major depression’ are presented before detailing its limitations in application.

Results. Challenges to the utility of ‘major depression’ are provided by examining its conceptual model, its validity, its utility and the limited information generated in aetiological and treatment efficacy studies.

Conclusion. It is argued that the concept of ‘major depression’ has led to sterility in depression research and clinical practice, and that there is a need for a paradigm shift in modelling and classifying the depressive disorders.