From depressive symptoms to depressive disorders: the relevance of thresholds

Jose L. Ayuso-Mateos, Roberto Nuevo, Emese Verdes, Nirmala Naidoo, Somnath Chatterji*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

159 Citations (Scopus)

Abstract

Background

Nosological boundaries for depressive disorders as well as the prevalence and impact of 'subsyndromal' depression remain unclear.

Aims

To examine the impact of subsyndromal depressive disorders on health status and to assess if depressive disorders lie on a continuum of severity.

Method

The sample was composed of randomly selected respondents from the general population in 68 countries from across the world participating in the World Health Organization's World Health Survey.

Results

The pattern of risk factors for depressive disorders was consistent across all types of depression (subsyndromal, brief depressive episode and depressive episode): odds ratios for females ranged between 1.49 and 1.80, and for the unemployed from 1.19 to 1.25. All types of depression produced a significant decrement in health status compared with no depression after controlling for demographic variables, income and country.

Conclusions

Subthreshold depressive disorders occur commonly all across the world and are associated with the same risk factors everywhere. They produce significant decrements in health and do not qualitatively differ from full-blown episodes of depression as currently defined, and lie on a continuum with more severe forms of depressive episodes but are distinct from normal mood changes.

Original languageEnglish
Pages (from-to)365-371
Number of pages7
JournalBritish Journal of Psychiatry
Volume196
Issue number5
DOIs
Publication statusPublished - May 2010

Keywords

  • QUALITY-OF-LIFE
  • SUBTHRESHOLD DEPRESSION
  • SUBSYNDROMAL DEPRESSION
  • MENTAL-DISORDERS
  • HEALTH SURVEYS
  • PRIMARY-CARE
  • PREVALENCE
  • CHINA
  • POPULATION
  • ILLNESS

Cite this

Ayuso-Mateos, J. L., Nuevo, R., Verdes, E., Naidoo, N., & Chatterji, S. (2010). From depressive symptoms to depressive disorders: the relevance of thresholds. British Journal of Psychiatry, 196(5), 365-371. https://doi.org/10.1192/bjp.bp.109.071191