The relationship between major and subthreshold variants of unipolar depression
Abstract
Recent epidemiological research in the general population and primary care demonstrated that a substantial proportion of disabling depressive syndromes do not meet the diagnostic criteria for major depression. This observation proposes less restrictive diagnostic definitions of depression. However, a gain in sensitivity may induce a substantial loss of specificity. A variety of diagnostic definitions of subthreshold depression has been proposed balancing both aspects. However, the less restrictive diagnostic definitions are, the lower the specificity. This report explores variants of subthreshold depression characterized by current and subsequent disability in a prospectively investigated sample of general practice patients (n = 400), recruited within the framework of the WHO study "Psychological Problems in Primary Care and a survey in the general population. Duration of episodes, recurrence and number of associated symptoms are the main diagnostic variables. Brief depression with multiple episodes per year (including recurrent brief depression as defined by ICD-10) is comparable to major depression by social disability and subsequent course in the sample under study.
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Most studies in the third group show that the presence of subthreshold symptoms, often residual symptoms after an MDD episode, is associated with an enhanced risk of a recurrent episode or relapse.
“Most of these studies show that the presence of ‘subthreshold’ symptoms (often called residual symptoms if occurring after an MDD episode) was associated with an enhanced risk of a (recurrent) episode or relapse”
From Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review (2019) · cites this paper as Maier et al. 1997
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- Authors
- Maier, W., Gänsicke, M., & Weiffenbach, O.
- Affiliations
- University of Bonn (DE)
- Corresponding author
- Maier, Wolfgang
- ORCID
- Maier, Wolfgang
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1997-08
- Volume
- 45
- Issue
- 1-2
- Pages
- 41-51
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2045208807
- Cited by
- 84
- References
- 23
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2015: 1 · 2014: 2 · 2012: 10
- FWCI
- 10.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- subthreshold depression, major depressive disorder, recurrent brief depression, diagnostic criteria, sensitivity and specificity, social dysfunction, depressive episode duration, depression recurrence, primary care patients, ICD-10
- MeSH terms
- Depression, Depressive Disorder, Diagnosis, Differential, Drug Resistance, Follow-Up Studies, Germany, Health Surveys, Humans, Terminology as Topic, Primary Health Care, Prospective Studies, Recurrence, Risk Factors, Sampling Studies, Severity of Illness Index, Time Factors, Prevalence, Databases, Factual, 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 ›
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