Subthreshold depression and depressive disorder : clinical characteristics of general medical and mental health specialty outpatients

by Cathy D. Sherbourne, Kenneth B. Wells, Ron D. Hays, William H. Rogers, M. Audrey Burnam, Lewis L. Judd


Purchase Print Copy

 FormatList Price
Add to Cart Paperback8 pages Free

The authors examined the clinical significance of depressive symptoms below the threshold for depressive disorder in outpatient samples. The subjects were 775 adult patients with current depressive disorder, 1,420 patients with subthreshold depression, and 1,767 hypertensive patients with and without depression, all of whom were visiting the offices of mental health specialists and general medical care providers in three U.S. cities. Data on demographic characteristics, severity of depression, extent of psychiatric and medical comorbidity, family psychiatric history, and treatment history for the patients with depressive disorder and those with subthreshold depression were compared. The percentage of patients with subthreshold depression who had a family history of depression (41 percent) was nearly as high as that of the patients with depressive disorder (59 percent). The two groups of patients had similar levels of medical and psychiatric comorbidity except for anxiety disorders, which were greater among the patients with depressive disorder. Among the hypertensive patients in the general medical sector, those with subthreshold depression were more similar to those with depressive disorder than to the nondepressed hypertensive patients. Treatment rates were considerably lower for patients with subthreshold depression than for patients with depressive disorder in the general medical sector, but they were similar in the mental health specialty sector. In these outpatients, subthreshold depression appeared to be a variant of affective disorder and was treated as such in the mental health specialty sector but not in the general medical sector. The findings emphasize the importance of treatment outcome studies of patients with subthreshold depression.

Originally published in: American Journal of Psychiatry, v. 151, no. 12, December 1994, pp. 1777-1784.

This report is part of the RAND Corporation Reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.