Subthreshold Syndromes of Depression and Anxiety in the Community

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Nearly 50% of individuals in the community meet threshold or subthreshold diagnostic criteria for depression or anxiety, with depression being far more common. Co-occurrence of anxiety and depression is common, as the majority of individuals who experience anxiety also manifest threshold- or subthreshold-level depression. In the current study, addition of subthreshold categories improved the coverage of treated cases in the community by nearly a third; 61% of subjects were diagnosed according to threshold criteria while 89% were diagnosed according to subthreshold categories. These results suggest that inclusion of subthreshold-level syndromes enhances the validity of diagnostic systems by increasing the proportion of treated cases that meet diagnostic criteria and by providing a more accurate representation of milder syndromes of depression and anxiety.

J Clin Psychiatry 1997;58(suppl 8):6–10