This valuable collection of chapters places the last 15 years of affective disorder research and clinical practice in a wonderful perspective. Although most of these chapters were directly derived from a conference held in Spoleto, Italy, in 1992, the distinguished group of contributors provide a lively debate on nosological and treatment issues, a debate that continues to this date. Given the interest and expertise of Akiskal and Cassano, the debate focuses on the chronic depressive disorders. The authors review the historical classic roots and changes in the conceptual framework of chronic and "minor" depressive disorders, driven by empirical diagnostic and treatment data, and conclude that the present nomenclature can embrace the spectrum and chronic conditions better than has been done previously. The authors consider their own clinical research and practice experiences in the United States, Brazil, Canada, England, and Germany and conclude that dysthymia, chronic major depression, and residual depressive states are here to stay, have reliable diagnostic criteria, and are amenable to psychopharmacological intervention. For example, it is argued that concurrent personality "clusters" or disorders do not diminish the likelihood of positive responses to pharmacotherapy in chronic depressive conditions. A number of other depressive subtypes are discussed, such as minor and recurrent brief depression, "chronic fatigue," atypical depression, "hysteroid" dysphoria, and two "childhood" conditions—chronic depression in childhood and concurrent depression with attention deficit hyperactivity disorder. Perhaps the most interesting debate occurs on the importance of neurotic depression: Roth and Mountjoy argue for the concept on one side and Maj argues on the other side.