CoChat
Sign Up
Cited by 302Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Research TopicsMental Health Treatment and Access

The depressive spectrum: diagnostic classification and course

Open access
Angst, J, Merikangas, K·1997·Journal of Affective Disorders
DOI 10.1016/s0165-0327(97)00057-8
Open this paper in CoChat — free accountOpen PDF

Abstract

The spectrum of depression is much wider than that reflected in the current diagnostic nomenclature. A large proportion of subjects with depression both in treatment and in the community fail to meet diagnostic criteria for either major depressive disorder (MDD) or dysthymia. Inclusion of subthreshold categories of depression dramatically improves the coverage of treated depression, particularly in community samples, and better enables the characterization of its longitudinal course. This paper investigates the application of diagnostic criteria for both threshold and subthreshold categories of depression in a prospective longitudinal community study of young adults from Zurich, Switzerland. We present the prevalence and treatment rates of each of the depressive subtypes, the degree of diagnostic overlap and the longitudinal stability of subthreshold and threshold categories of depression. The findings indicate that the prevalence rates of subthreshold categories of depression are quite high in the community, and that a substantial proportion of subthreshold depressives, particularly those with recurrent depression, receive treatment. There is a strong tendency for individuals to meet multiple depressive subtypes over time, with little stability of individual categories among those who continue to manifest depression over a 15-year period. The prospective longitudinal data reveal that major depression is both an antecedent to and sequela of subthreshold categories, providing evidence for the validity of the spectrum concept of depression. However, the need for a threshold for the symptom criteria is suggested by the lack of predictive value of minor depression and depressive symptoms only. These result suggest that both the current symptom threshold for a depressive syndrome and recurrence, but not the minimum duration of depressive episodes, are important components of the classification of depression.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s0165-0327(97)00057-8

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Only about half as many people have depression at a point in time as have it in a 12-month period, given that average episode duration is about 6 months, although there is wide variation around this average.

    “Only about half as many people have depression at a point in time given that average episode duration is about 6 months, although there is wide variation around this average. 135”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [135]

  • Retrospectively-reported lifetime prevalence of depression from community epidemiological surveys with adults aged 18-74 years in 28 countries averaged 10·6% across countries (interquartile range of 6-14%).

    “Retrospectively-reported lifetime prevalence of depression from community epidemiological surveys with adults aged 18-74 years in 28 countries 135 averaged 10·6% across countries (interquartile range of 6-14%).”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [135]

  • Based on data from the WMH surveys, the average morbid risk of depression at age 75 is projected to be 19·6% (i.e., it is estimated that almost one in five individuals around the world will have experienced depression by 75 years of age).

    “Based on data from the WMH surveys, the average morbid risk of depression at age 75 is projected to be 19·6% (i.e., it is estimated that almost one in five individuals around the world will have experienced depression by 75 years of age). 135”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [135]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Masson Medecine et Psychotherapie, Paris, Milan, criteria: rationale and reliability. Arch. Gen. Psychiatry 35, Barcelona, pp. 29-42. 773-779.
  2. Bishop, Y., Fienberg, S., Holland, P., 1975. Discrete Multivariate the medical outcomes study. JAMA 262, 914-919. Analysis. MIT Press, Cambridge, MA.
  3. Derogatis, R.L., 1977. Symptom Checklist 90, R-Version Manual It is very clear that an increasing number of I: Scoring, Administration and Procedures for the SCL-90. diagnostic categories are emerging in the field of Johns Hopkins University Press, Baltimore.

Cited by

Sorted by citations

Related

Authors
Angst, J., & Merikangas, K.
Affiliations
  • Psychiatrische Universitätsklinik Zürich (CH)
  • Yale University (US)
Corresponding author
Angst, J
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
1997-08
Volume
45
Issue
1-2
Pages
31-40
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/s0165-0327(97)00057-8
OpenAlex
W1964441651
Cited by
302
References
27
Citations by year
2026: 2 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 2 · 2020: 5 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 7 · 2015: 9 · 2014: 14 · 2013: 9 · 2012: 19
FWCI
19.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (K02-00499)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
subthreshold depression, major depressive disorder, dysthymia, minor depression, diagnostic classification, diagnostic overlap, longitudinal stability, prevalence, treatment rates, young adults, depression recurrence, symptom threshold
MeSH terms
Adolescent, Adult, Chronic Disease, Cross-Sectional Studies, Depression, Depressive Disorder, Female, Humans, Male, Mental Health Services, Terminology as Topic, Prospective Studies, Recurrence, Risk Factors, Sampling Studies, Severity of Illness Index, Switzerland, Prevalence, Confidence Intervals, Logistic Models, Odds Ratio, Cost of Illness, Sex Distribution, Disease Progression

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review