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Cited by 102Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessTreatment of Major Depression

How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review

Carrellas, Nicholas W., Biederman, Joseph, Uchida, Mai·2017·Journal of Affective Disorders
DOI 10.1016/j.jad.2016.12.037
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Abstract

Introduction Major Depressive Disorder (MDD) among youth is a public health concern. Our aim was to examine the current body of knowledge to better characterize the prevalence and morbidity associated with subthreshold forms of MDD among youth. Given that MDD tends to develop gradually over time, we hypothesized a high prevalence and considerable impairment associated with youth suffering from depressive symptoms that fall short of full, syndromic status.Methods A literature search was conducted using PubMed exclusively to identify studies assessing the prevalence and clinical characteristics of subthreshold MDD in adolescents.Results Six scientific papers that met our priori inclusion and exclusion criteria were identified. All papers sampled adolescents. The prevalence of subthreshold MDD ranged from 5% over the past year, to 29% over the two weeks prior to screening. These papers reported clinically significant morbidity associated with subthreshold MDD among adolescents, with evidence for elevated rates of psychiatric comorbidities, impaired functioning in social and familial domains, increased suicidality, and frequent mental health service utilization.Limitations Though we examined a sizeable and diverse sample, we only identified six cross-sectional informative studies for this review. Variability of subthreshold MDD and major outcome definitions across studies, likely limits the specificity of findings.Conclusions Subthreshold MDD is prevalent among youth, and is associated with emotional and social impairments that reach the level of obtaining clinical care. These findings could lead to early intervention efforts aimed at mitigating the adverse outcomes associated with subthreshold MDD as well as the progression to full syndrome MDD. Our review documents that regardless of whether progression to full diagnostic status occurs, this condition is morbid.

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  • 12-month prevalence of depression among women was somewhat higher in Africa and the Americas (5·8%) and somewhat lower in the Western Pacific (4·2%) than in the remaining regions of the world (5%).

    “These estimates suggest that 12-month prevalence among women was somewhat higher in Africa and the Americas (5·8%) and somewhat lower in the Western Pacific (4·2%) than in the remaining regions of the world (5%).”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [139]

  • Among men, estimated 12-month prevalence of depression was highest in Africa (4·8%), lowest in the Western Pacific (2·8%), and intermediate in other regions (3·5-3·8%).

    “Among men, estimated prevalence was highest in Africa (4·8%), lowest in the Western Pacific (2·8%), and intermediate in other regions (3·5-3·8%).”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [139]

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Authors
Carrellas, N. W., Biederman, J., & Uchida, M.
Affiliations
  • Massachusetts General Hospital (US)
  • Harvard University (US)
Corresponding author
Uchida, Mai
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2017-03
Volume
210
Pages
166-173
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2016.12.037
OpenAlex
W2562397356
Cited by
102
References
25
Citations by year
2026: 10 · 2025: 17 · 2024: 10 · 2023: 12 · 2022: 9 · 2021: 13 · 2020: 9 · 2019: 10 · 2018: 8 · 2017: 4
FWCI
9.81
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (acceptedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
adolescents, prevalence, morbidity, psychiatric comorbidity, social functioning, family functioning, suicidality, mental health service utilization, early intervention
MeSH terms
Adolescent, Major Depressive Disorder, Female, Humans, Male, Comorbidity, Prevalence, Disease Progression

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