The impact of clinical significance criteria on subthreshold depression prevalence rates.
OBJECTIVE
To examine and compare prevalence rates of subthreshold depression (SD) based on symptom count only as well as additional categorically and dimensionally operationalized clinical significance (CS) criteria.


METHODS
Data were drawn from the German National Health Survey (n = 4181). DSM-IV-SD and categorically defined CS criteria were operationalized by means of the Munich-Composite International Diagnostic Interview, dimensionally defined CS criteria by means of the SF-36-mental component summary score (MCS) Scale.


RESULTS
Four-week and 12-month prevalence rates of SD ranged from 0.7% (MCS-CS criteria) to 1.8% (symptom count) and 1.8% to 6.8% respectively. Prevalence rates of SD were lower than those of Major Depression (5.7% and 10.9%). Within linear regression models, the association between SD and health care utilization variables remained insignificant.


CONCLUSIONS
Although prevalences rates of SD are bound to the CS criterion used, they are lower than for Major Depression. The use of a CS criterion is recommended to avoid pathologizing human behavior.
Baumeister
H
H
Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany. harald.baumeister@psychologie.uni-freiburg.de
Morar
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005858:Germany; D006296:Health Services / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010552:Personality Assessment; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult