Literature DB >> 23330982

Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk.

Judit Balázs1, Mónika Miklósi, Agnes Keresztény, Christina W Hoven, Vladimir Carli, Camilla Wasserman, Alan Apter, Julio Bobes, Romuald Brunner, Doina Cosman, Pádraig Cotter, Christian Haring, Miriam Iosue, Michael Kaess, Jean-Pierre Kahn, Helen Keeley, Dragan Marusic, Vita Postuvan, Franz Resch, Pilar A Saiz, Merike Sisask, Avigal Snir, Alexandra Tubiana, Airi Varnik, Marco Sarchiapone, Danuta Wasserman.   

Abstract

BACKGROUND: Subthreshold-depression and anxiety have been associated with significant impairments in adults. This study investigates the characteristics of adolescent subthreshold-depression and anxiety with a focus on suicidality, using both categorical and dimensional diagnostic models.
METHODS: Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, comprising 12,395 adolescents from 11 countries. Based on self-report, including Beck Depression Inventory-II (BDI-II), Zung Self-Rating Anxiety Scale (SAS), Strengths and Difficulties Questionnaire (SDQ) and Paykel Suicide Scale (PSS) were administered to students. Based on BDI-II, adolescents were divided into three groups: nondepressed, subthreshold-depressed and depressed; based on the SAS, they were divided into nonanxiety, subthreshold-anxiety and anxiety groups. Analyses of Covariance were conducted on SDQ scores to explore psychopathology of the defined groups. Logistic regression analyses were conducted to explore the relationships between functional impairments, suicidality and subthreshold and full syndromes.
RESULTS: Thirty-two percent of the adolescents were subthreshold-anxious and 5.8% anxious, 29.2% subthreshold-depressed and 10.5% depressed, with high comorbidity. Mean scores of SDQ of subthreshold-depressed/anxious were significantly higher than the mean scores of the nondepressed/nonanxious groups and significantly lower than those of the depressed/anxious groups. Both subthreshold and threshold-anxiety and depression were related to functional impairment and suicidality.
CONCLUSIONS: Subthreshold-depression and subthreshold-anxiety are associated with an increased burden of disease and suicide risk. These results highlight the importance of early identification of adolescent subthreshold-depression and anxiety to minimize suicide. Incorporating these subthreshold disorders into a diagnosis could provide a bridge between categorical and dimensional diagnostic models.
© 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

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Mesh:

Year:  2013        PMID: 23330982     DOI: 10.1111/jcpp.12016

Source DB:  PubMed          Journal:  J Child Psychol Psychiatry        ISSN: 0021-9630            Impact factor:   8.982


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