Paula J. Clayton, MD died on September 4 in Pasadena, California after a short illness at the age of 86. She broke new ground in psychiatry in many ways —as a leading member of the Washington University group that revolutionized psychiatric diagnosis in America: as the first woman chair of major academic departments of psychiatry, and by her new findings on the diagnosis, clinical course, and treatment of depression. She was a beloved figure in psychiatry and a role model for the few women in psychiatry at the time in leadership roles or who aspired to them. She lit up any room that she entered with her warm smile, her sense of humor, and her sharp thinking.

A native of St. Louis, she ventured to the University of Michigan for college, where she later received the Athena Award for the outstanding female alumna. She returned to St. Louis for medical school and residency at Washington University, where she was Alpha Omega Alpha. She joined the faculty there in 1965 and quickly rose through the ranks to full professor in 1974. In 1980 she became the chair of the department of psychiatry at the University of Minnesota, where she spent 19 years. In 2006 she was coaxed out of semi-retirement in New Mexico to become the Medical Director at the American Foundation for Suicide Prevention, a role she held until 2014.

She made fundamental contributions to our knowledge of depression—diagnosis, clinical course, bereavement, suicide, and genetics. She published over 170 scholarly papers and several books.

Prior to the middle of the twentieth century, the diagnostic system in American psychiatry was dominated by psychoanalytic principles and based on putative intrapsychic mechanisms. The Washington University group had a profoundly different approach that was based upon the medical model and required empirical validation. The group’s early members were Eli Robins, George Winokur, Sam Guze, Ted Reich, and Paula Clayton. These principles were developed in the 1950’s and 1960’s, and first published by a psychiatric resident at Washington University as the Feighner Criteria in 1972. Interestingly this publication became the most cited article in psychiatry for many years! These criteria were later used by Robert Spitzer as the basis for DSM III, which was published in 1980 and forever shifted the paradigm in American practice and research.

Paula was a quintessential mid-westerner, and embodied the distinctive demeanor of the Washington University group—to be extraordinarily gracious and noncontentious in manner, and fair and friendly to the core, but completely uncompromising on any matter of principle.

A related contribution was encapsuled in her 1969 book entitled Manic Depressive Illness, and was coauthored by George Winokur and (then resident) Ted Reich. It described a study of over 400 consecutive admissions with affective disorders who were systematically evaluated, including detailed family histories. Their findings, described in the book, demonstrated the separation of manic depressive illness (i.e., bipolar disorder) from depressive illness.

She was extremely active in professional societies, including the ACNP, where she was a fellow emeritus. She served on Council and on many committees. She also served as president of the American Psychopathological Society, the Psychiatric Research Society, and the Society of Biological Psychiatry.

She was associate editor of the American Journal of Psychiatry and was a member of the editorial board.

Among her many awards was the Lifetime Research Award from the National Depressive and Manic Depressive Association.

She leaves three children and seven grandchildren, and many, many friends who will miss her very much.