title: Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk.
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.
authors: Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary. judit.agnes.balazs@gmail.com
authors: Judit
authors: J
authors: Balázs
authors: Mónika
authors: M
authors: Miklósi
authors: Agnes
authors: A
authors: Keresztény
authors: Christina W
authors: CW
authors: Hoven
authors: Vladimir
authors: V
authors: Carli
authors: Camilla
authors: C
authors: Wasserman
authors: Alan
authors: A
authors: Apter
authors: Julio
authors: J
authors: Bobes
authors: Romuald
authors: R
authors: Brunner
authors: Doina
authors: D
authors: Cosman
authors: Pádraig
authors: P
authors: Cotter
authors: Christian
authors: C
authors: Haring
authors: Miriam
authors: M
authors: Iosue
authors: Michael
authors: M
authors: Kaess
authors: Jean-Pierre
authors: JP
authors: Kahn
authors: Helen
authors: H
authors: Keeley
authors: Dragan
authors: D
authors: Marusic
authors: Vita
authors: V
authors: Postuvan
authors: Franz
authors: F
authors: Resch
authors: Pilar A
authors: PA
authors: Saiz
authors: Merike
authors: M
authors: Sisask
authors: Avigal
authors: A
authors: Snir
authors: Alexandra
authors: A
authors: Tubiana
authors: Airi
authors: A
authors: Varnik
authors: Marco
authors: M
authors: Sarchiapone
authors: Danuta
authors: D
authors: Wasserman
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D010555:Personality Inventory / Q000706:statistics & numerical data; D062706:Prodromal Symptoms; D011594:Psychometrics; D011599:Psychopathology; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology* / Q000706:statistics & numerical data; D000092864:Suicide Prevention