Subthreshold depressive disorder in adolescents: Predictors of escalation to full-syndrome depressive disorders

Daniel N. Klein, Stewart A Shankman, Peter M. Lewinsohn, John R. Seeley

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

OBJECTIVES:: Subthreshold depressive disorder is one of the best established risk factors for the onset of full-syndrome depressive disorders. However, many youths with subthreshold depressive disorder do not develop full-syndrome depression. We examined predictors of escalation to full-syndrome depressive disorders in a community sample of 225 adolescents with subthreshold depressive disorder. METHOD:: Criteria for subthreshold depressive disorder were an episode of depressed mood or loss of interest or pleasure lasting at least 1 week and at least two of the seven other DSM-IV-associated symptoms for major depression. Participants were assessed four times from mid-adolescence to age 30 years using semistructured diagnostic interviews. RESULTS:: The estimated risk for escalation to full-syndrome depressive disorders was 67%. Five variables accounted for unique variance in predicting escalation: severity of depressive symptoms, medical conditions/symptoms, history of suicidal ideation, history of anxiety disorder, and familial loading for depression. Adolescents with three or more risk factors had an estimated 90% chance of escalating to full-syndrome depressive disorder, compared with 47% of adolescents with fewer than three risk factors. CONCLUSIONS:: These data may be useful in identifying a subgroup of youths with subthreshold depressive disorder who are at especially high risk for escalating to full-syndrome depressive disorders.

Original languageEnglish (US)
Pages (from-to)703-710
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume48
Issue number7
DOIs
StatePublished - Jul 2009

Keywords

  • Escalation
  • Minor depression
  • Predictors
  • Subthreshold depressive disorder

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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