Clinical significance and comorbidity of subthreshold depression and anxiety in the community.
OBJECTIVE
This report examines: 1) the magnitude of co-occurrence of threshold and subthreshold-level depression and anxiety in the community, and 2) the relationship between comorbidity and the diagnostic level of depression and anxiety and their clinical correlates.


METHODS
A community sample of 591 subjects was interviewed prospectively five times across 15 years from the ages of 20-35. The diagnostic interview allowed the assignment of diagnoses according to DSM-III criteria and operational definitions of subthreshold syndromes.


RESULTS
1) Comorbidity between depression and anxiety was more frequent when one syndrome reached threshold level; 2) comorbidity at both the threshold and subthreshold diagnostic levels was associated with symptom severity, disability and treatment, whereas the diagnostic level was associated with disability and suicidal attempts.


CONCLUSIONS
The systematic association between comorbidity across diagnostic threshold levels of anxiety and depression with clinical correlates suggests the importance of a more dimensional approach to their classification.
Preisig
M
M
University Department of Adult Psychiatry, Lausanne, Switzerland.
Merikangas
K R
KR
Angst
J
J
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male