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Am J Psychiatry 1996; 153:1411-1417
Copyright © 1996 by American Psychiatric Association
Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population
LL Judd, MP Paulus, KB Wells and MH Rapaport
Department of Psychiatry, University of California, San Diego 92093- 0603, USA.
OBJECTIVE: The authors' goal was to evaluate the association between
impairment in daily function and subsyndromal depressive symptoms as well
as major depression to determine the economic and societal significance of
these conditions. METHOD: Using 12-month prevalence data gathered by the
National Institute of Mental Health (NIMH) Epidemiologic Catchment Area
Program (ECA), based on responses to the NIMH Diagnostic Interview
Schedule, the authors divided the 2,393 subjects from the Los Angeles ECA
site into three groups: subjects with subsyndromal depressive symptoms (N =
270), major depression (N = 102), and no depressive disorder or symptoms (N
= 2,021). The groups were compared on 10 domains of functional outcome and
well-being. RESULTS: Significantly more subjects with depressive symptoms
than subjects who had no disorder reported high levels of household strain,
social irritability, and financial strain as well as limitations in
physical or job functioning, restricted activity days, bed days, and poor
health status. Significantly more subjects with major depression than
subjects with no disorder reported major financial losses, bed days, high
levels of financial strain, limitations in physical or job functioning, and
poor health status. Except for lower self-ratings of health status, no
significant differences were found between subjects with subsyndromal
symptoms and those with major depression. CONCLUSIONS: Significantly more
people with subsyndromal depressive symptoms or major depression reported
impairment in eight of 10 functional domains than did subjects with no
disorder. The high 1-year prevalence of subsyndromal depressive symptoms,
combined with the associated functional impairment, emphasizes the clinical
and public health importance and need for additional investigations into
these symptoms.
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