In Memoriam: Robert M. A. Hirschfeld, MD, 1943–2023

J Clin Psychiatry 2023;84(3):23f14847

To share: https://doi.org/10.4088/JCP.23f14847

© 2023 Physicians Postgraduate Press, Inc.

The last several years have sadly witnessed the passing of a number of pioneering giants in the world of mood disorders research, names that may not always be so familiar to a younger generation of psychiatrists. Yet those of us who came of age professionally in the post-lithium era of mood disorders research were acculturated by the ideas and work of our senior colleagues, those whose efforts gave rise to modern nosology and therapeutics. Robert M. A. Hirschfeld, MD, MSc, who died on February 10, 2023, was solidly within this pantheon.

Born and raised in Detroit, Michigan, Bob received his undergraduate degree from the Massachusetts Institute of Technology and obtained his MD from the University of Michigan, followed by a residency in psychiatry at Stanford University, where he also obtained an MSc in operations research. He then spent 18 years at the National Institute of Mental Health (NIMH), serving as Chief of the Mood, Anxiety and Personality Disorders Research Branch, and was the Clinical Director of NIMH’s Depression/Awareness, Recognition, and Treatment Program. He went on to serve for nearly 25 years as the Titus H. Harris Chair, Harry K. Davis Professor, and Professor and Chair of the Department of Psychiatry at the University of Texas Medical Branch at Galveston. In 2015 Bob left Galveston to be nearer to his children and grandchildren in New York City and joined the faculty of the Weill Medical College of Cornell University as the DeWitt Wallace Senior Scholar and Professor of Psychiatry. From among his more than 200 scientific papers and abstracts in the peer-reviewed literature, as well as innumerable book chapters, his writings addressed the interface of anxiety and mood disorders, the impact of personality disorders on depression, the epidemiology and functional impact of bipolar disorder in community samples, the management of adverse psychotropic drug effects, and innovative clinical trials with an array of compounds that nowadays hold commonplace use for treating mood and anxiety disorders. When clinicians speak of the frequent misdiagnosis of bipolar disorder as major depression, and delays of up to 10 years in establishing an accurate diagnosis of bipolar disorder, they are referring to Bob’s seminal study conducted with the National Depressive and Manic-Depressive Association, published in this journal 20 years ago.¹

Among the many professional recognitions he received over his lifetime were the 2003 Nola Maddox Falcone Prize for Outstanding Achievement in Affective Disorders Research (later named the Colvin Prize) awarded by the Brain and Behavior Research Foundation (BBRF; formerly the National Alliance for Research in Schizophrenia and Depression, or NARSAD). In 2002, BBRF also awarded him a Distinguished Investigator Grant. Bob received the 2010 Award for Research in Mood Disorders from the American College of Psychiatrists, the Edward A. Strecker, MD Award, the Texas Society of Psychiatric Physicians Psychiatric Excellence Award, the Gerald L. Klerman Lifetime Research Award from the National Depressive and Manic-Depressive Association, the Special Presidential Commendation from the American Psychiatric Association, the Gerald L. Klerman Award for Panic Disorder from the World Psychiatric Association, the Distinguished Achievement Award from the University of Michigan, and the Outstanding Service Medal from the Alcohol, Drug Abuse, and Mental Health Administration. Bob was elected to the American College of Neuropsychopharmacology in 1989 and was a fellow emeritus at the time of his death. He was also listed for many years among The Best Doctors in America and America’s Top Doctors.

Bob was a tireless and productive clinician-scientist as well as one of the kindest, humblest, and most generative of mentors and colleagues one could hope to work with. The mark he has left on our field is immense. Bob was one of the original investigators in the Clinical Studies of the NIMH Psychobiology of Depression Research Program, one of the first multisite clinical follow-up studies that addressed treatment effectiveness versus efficacy. There would likely have been no STAR*D or STEP-BD NIMH studies without the trails blazed by this earlier work. Bob later spearheaded clinical trials of divalproex sodium for the treatment of acute mania and helped to develop the concept of rapid oral loading strategies to hasten treatment response. He developed the Mood Disorders Questionnaire (MDQ), one of the first and still most widely used screening tools for bipolar disorder that has now been translated into 19 languages. As an internationally renowned expert in the phenomenology and treatment of bipolar disorder, he chaired the original and revised versions of the American Psychiatric Association’s work group to develop practice guidelines for treatment of patients with bipolar disorder. He contributed to the Texas Medication Algorithm Project and to treatment guidelines from the International Society for Bipolar Disorders. He also held a deep commitment to research on suicide prevention, having served on the Board of Directors and then as President of the American Foundation for Suicide Prevention.

Bob epitomized the role of scientific consultant and humanitarian-activist in the world of patient advocacy. He spent 6 years as Chair of the Scientific Advisory Board of the National Depressive and Manic-Depressive Association (later renamed the Depression and Bipolar Support Alliance, or DBSA) and was awarded their Jan Fawcett Humanitarian Award. He was a member of the Scientific Advisory Council of NARSAD, the scientific advisory board of the International Bipolar Foundation, and the scientific advisory board of the Anxiety and Depression Association of America. When one saw him at professional meetings, it was hard to know if his presence was mainly on behalf of a patient advocacy organization, as an investigator sharing new findings to colleagues about the epidemiology and pharmacotherapy of bipolar disorder, or (usually) both. He was an inspiration to generations of clinical investigators and practitioners involved in the treatment of mood disorders. Particularly for those who aspire to stand on the shoulders of giants, the legacy of his work will no doubt remain impactful for many generations to come.

Published online: March 20, 2023.