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Clinical significance and comorbidity of subthreshold depression and anxiety in the community

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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.

Method: 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.

Conclusion: 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.

Keywords: anxiety disorder; comorbidity; depressive disorder; epidemiological studies; subthreshold disorders

Document Type: Original Article

Affiliations: 1: University Department of Adult Psychiatry, Lausanne, Switzerland 2: Department of Epidemiology and Public Health, Psychiatry, and Psychology, Yale University School of Medicine, New Haven, CT 06510, USA and 3: Psychiatric University Hospital Zurich, Zurich, Switzerland

Publication date: August 1, 2001


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