Most existing SMD research has been conducted by a single intramural group at NIMH. It is imperative that investigations of SMD be expanded to other research groups to ensure that results generalize to broad clinical settings. Additional research is required to delineate clinical phenomenology that will inform subsequent efforts at diagnostic classification. Further work is also necessary to establish the appropriate foundation for future clinical interventions research. This should include pilot studies of various medication classes that might prove useful in management of SMD, as well as examination of various outcome measures that are likely to be useful in both medication and psychosocial intervention trials.