Service Utilization and Social Morbidity Associated With Depressive Symptoms in the Community

Johnson, Jim; Weissman, Myrna M.; Klerman, Gerald L.

doi:10.1001/jama.1992.03480110054033

Cited by 555 publications

(169 citation statements)

References 16 publications

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“…Although the risk for disability from minor depression without mood disturbance was not significant compared to normal subjects, more disability days were attributed to this category versus MD because of the high prevalence of SSD. Johnson et al [1992] measured other parameters of disability: use of medical services for emotional disturbances, use of psychotropic medication, self reported health, loss of 1 week from work due to emotional problems, and attempted suicide. The prevalence of such adverse outcomes was significantly higher in patients with lifetime depressive symptoms (with or without depressed mood) as compared with normal subjects (P ≤ 0.001).…”

Section: Disability and Impairment Associated With Ssdmentioning

confidence: 99%

“…Moreover, Johnson et al [1992] measured the attributable risk (AR), which denoted the proportion of the disability parameters studied that is attributable to each depressive category. They concluded, "from a population, societal, or 'service burden' perspective, more medical service utilization, suicide attempts, and other indicators of impairment result from individuals with depressive symptoms than from cases explicitly defined by the American Psychiatric Association's diagnostic manuals" (p. 1481).…”

Section: Disability and Impairment Associated With Ssdmentioning

confidence: 99%

“…Studies revealed that the demographics and clinical characteristics of subthreshold states were comparable to those of major depression [Broadhead et al, 1990;Angst, 1990;Sherbourne et al, 1994;Judd et al, 1994]. Additional studies focused on the psychosocial, occupational, and disability impairment associated with these subthreshold states [Wells et al, 1989;Angst, 1990;Johnson et al, 1992;Skodol et al, 1994;Judd et al, 1996]. This emphasis in focus was the major step towards establishing the clinical significance of these states.…”

Section: Introductionmentioning

confidence: 99%

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Subsyndromal symptomatic depression: A new concept

Sadek¹,

Bona²

2000

Depress. Anxiety

115

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Although DSM‐IV acknowledged the clinical significance of some subthreshold forms of unipolar depression, such as minor depression (MinD) and recurrent brief depression (RBD), clinicians continued to struggle with the concept of “subthreshold” depression. A substantial number of patients continued to present with depressive symptoms that still did not satisfy any DSM‐IV diagnosis. Generally, these patients failed to complain of anhedonia and depressed mood, a criterion that DSM‐IV mandates for any diagnosis of depression. Therefore, researchers reexamined the question of whether this cluster of depressive symptoms, in the absence of anhedonia and depressed mood, was clinically significant. Some researchers labeled this cluster of symptoms, “subsyndromal symptomatic depression” (SSD). Specifically, SSD is defined as a depressive state having two or more symptoms of depression of the same quality as in major depression (MD), excluding depressed mood and anhedonia. The symptoms must be present for more than 2 weeks and be associated with social dysfunction. Using Medline Search, the authors reviewed the literature on the epidemiology, demographics, clinical characteristics, and psychosocial impairment of SSD. SSD is found to be comparable in demographics and clinical characteristics to MD, MinD, and dysthymia. SSD is also associated with significant psychosocial dysfunction as compared with healthy subjects. Further, it has significant risk for suicide and future MD. Few studies have been conducted on the treatment of SSD. The high prevalence of SSD, the significant psychosocial impairment associated with it, and the chronicity of its course make subsyndromal symptomatic depression a matter for serious consideration by clinicians and researchers. Depression and Anxiety 12:30–39, 2000. © 2000 Wiley‐Liss, Inc.

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Section: Disability and Impairment Associated With Ssdmentioning

confidence: 99%

Section: Disability and Impairment Associated With Ssdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subsyndromal symptomatic depression: A new concept

Sadek¹,

Bona²

2000

Depress. Anxiety

115

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“…Notable among these studies was that conducted by the National Institute of Mental Health (NIMH) Epidemiological Catchment Area Program [18], which showed that patients with major depressive disorders or sub-syndromal depression experienced higher levels of household strain, social irritability, financial stress, limitation in occupational functioning, poor health status and days lost from work [19] [20]. Another study also found that women with major depressive disorder had impairment in family, marital, occupational and leisure activities [21].…”

Section: Introductionmentioning

confidence: 99%

A Case Control Study of Subjective Quality of Life in Outpatients with Depression

Davou¹,

Audu²,

Akinhanmi³

et al. 2017

OJPsych

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Background: Depression is one of the leading causes of disability including impairment in the subjective Quality of Life (QOL) of the patient. Unfortunately, only a fraction receives the correct diagnosis and treatment in general practice. This study aims to determine the subjective Quality of Life of depressed patients. Method: A representative sample of adults, 18 years and above (100 each for cases and controls), were assessed for QOL using the World Health Organization Quality of Life instrument (WHOQOL-BREF). Respondents were also evaluated for socio-demographic factors. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview. Severity of depression was measured using Hamilton's Rating Scale for Depression and global functioning was assessed with the Global Assessment of Functioning scale. Results: Majority of the participants were females (62.0%) and young with a mean age of 39.11 ± 12.40 years. Overall subjective QOL (P < 0.033), as well as the physical (P < 0.002), psychological (P < 0.001), social (P < 0.006) and environmental (P < 0.048) domains were significantly impaired in depressed patients compared to healthy control. Global functioning was also impaired (P < 0.001) in depressed patients compared to healthy control. Conclusion: The finding of the study showed that depression is a serious illness that affects the patient's perception of the quality of his/her life. It is therefore very necessary to innovate better treatment modalities to reduce its burden.

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“…It is not known whether such symptoms are prodromal to or sequelae of major depression, or what therapeutic interventions, if any, are warranted. Several recent studies have shown that depressive symptoms are associated with significant social morbidity and service utilization as measured by days lost from work, disability, diminished sense of well being, utilization of medical services, use of tranquilizers, sleeping pills, and antidepressants, and visits to medical clinics (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

What are the public health implications of subclinical depressive symptoms?

Horwath¹,

Johnson²,

Klerman³

et al. 1994

Psych Quart

Self Cite

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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.

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Service Utilization and Social Morbidity Associated With Depressive Symptoms in the Community

Cited by 555 publications

References 16 publications

Subsyndromal symptomatic depression: A new concept

Subsyndromal symptomatic depression: A new concept

A Case Control Study of Subjective Quality of Life in Outpatients with Depression

What are the public health implications of subclinical depressive symptoms?

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