2448 – Adolescent Subthreshold Depression and Anxiety

Abstract

A significant proportion of individuals with substantial functional impairment who either identify themselves as psychiatric patients or who are referred for psychiatric evaluation by their families/teachers or other clinicians may not receive a standard diagnosis based on the current classification systems due to an insufficient number or duration of symptoms. Their conditions are labeled as subthreshold mental disorders. This presentation aims to give an overview on the current knowledge on adolescent subthreshold depression and anxiety.

Based on the literature the presence of subthreshold depression and anxiety is associated with more medical comorbidity, more workdays lost, greater use of services for medical and mental health problems and increased suicide risk. Adolescents with subthreshold conditions have an increased risk for developing future full syndrome disorders than individuals without these conditions. People with subthreshold conditions report significantly more social dysfunction and disability compared to those with several common general medical conditions such as hypertension or diabetes.

The results of the Saving and Empowering Young Lives in Europe (SEYLE) study - as the risk for increased burden of disease and suicide risk among adolescents with subthreshold-depression/anxiety is between the risk for those non-depressed/nonanxious and full syndrome depressed/anxious - contribute to the current discussions about the advantages and disadvantages of categorical and dimensional classification systems: these findings suggest that subthreshold and full DSM-IV-TR depression/anxiety could be on the same continuum. Inputting subthreshold disorders into the diagnostic systems could provide a bridge between categorical and dimensional diagnostic models.