What are the public health implications of subclinical depressive symptoms?
Longitudinal data from a community study of 9900 adults in the United States show that persons with depressive symptoms, as compared to those without such symptoms, were 4.4 times more likely to develop a first onset major depression over one year. The attributable risk, a measure which reflects both the relative risk associated with depressive symptoms (4.4) and the prevalence of exposure to that risk (24%) and is a useful measure for documenting burden of a risk to the community, indicated that more than 50% of first onset major depressions are associated with prior depressive symptoms. Since depressive symptoms have a high prevalence in the community, but are often unrecognized and untreated in clinical practice, we conclude that their identification and the development of effective treatments could have public health implications for the prevention of associated social morbidity, service utilization and major depression.
Unable to display preview. Download preview PDF.
- 5.Essen-Moller E, Hagnell O. The frequency and risk of depression within a rural group in Scania. Acta Psychiatr Scand 162(suppl):28–32. 1961.Google Scholar
- 6.Hallstrom T. Mental disorder and sexuality in the climacteric. A study in psychiatric epidemiology. In: Forsman E, ed. Reports from the Psychiatric Research Centre, St. Jorgan's Hospital, University of Goteborg, Sweden, Vol. 6, Jacobs A, trans. Copenhagen: Scandinavian University Books, 1973.Google Scholar
- 7.Brown GW, Harris T. Social Orgins Of Depression. A Study of Psychiatric Disorder in Women. London: Tavistock Publications, 1978.Google Scholar
- 8.Eaton WW, Kramer M, Anthony JC, Dryman A, Shapiro S, Locke BZ. The incidence of specific DIS/DSM-III mental disorders: data from the NIMH Epidemiologic Catchment Area Program. Acta Psychiatr Scan 79:163–176. 1989.Google Scholar
- 9.Anthony JC, Petronic KR. Suspected risk factors for depression among adults 18–44 years old. Epidemiology 2:123–132, 1990.Google Scholar
- 11.Mausner JS, Bahn AK. Epidemiology. Philadelphia: WB Saunders, 322–324. 1974.Google Scholar
- 12.Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking. Brit Med J 1071–1081. 1956.Google Scholar
- 13.Kelsey JL, Thompson WD, Evans AS. Methods in Observational Epidemiology. New York: Oxford University Press, 1986.Google Scholar
- 15.Eaton WW, Kessler LG. Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Orlando, Fla: Academic Press Inc, 1985.Google Scholar
- 18.Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C. Affective disorders. In: Robins LN, Regier DE, eds. Psychiatric Disorders in America. New York: The Free Press, 1991.Google Scholar
- 26.Cooke DJ, Hole DJ. The etiological importance of stressful life events. Brit J Psychiatry 143:397–400. 1983.Google Scholar
- 29.Shepherd M, Cooper B, Brown AC, Kalton G. Psychiatric illness in general practice, 2nd ed. Oxford: Oxford University Press, 1981.Google Scholar
- 30.Regier DA, Goldberg ID, Taube CA. The de facto US mental health services system. Arch Gen Psych 35:685–693. 1978.Google Scholar
- 31.Goldberg D. Detection and assessment of emotional disorders in a primary care setting. Int J Ment Health 8:30–48. 1979.Google Scholar
- 32.Clare AW, Blacker R. Some problems affecting the diagnosis and classification of depressive disorders in primary care. In: Shepherd M, Wilkinson G, Williams P (eds). Mental illness in primary care settings. London: Tavistock Publications, 1986.Google Scholar
- 34.Sharp D, Morrell D. The psychiatry of general practice. In: Williams P, Wilkinson G, Rawnsley K, eds. The Scope of Epidemiologic Psychiatry: Essays in Honour of Michael Shepherd. London, England: Routledge & Kegan Paul, 1989.Google Scholar