Sub-syndromal depression in adolescents attending primary care: frequency, clinical features and 6 months outcome

Soc Psychiatry Psychiatr Epidemiol. 2013 May;48(5):735-44. doi: 10.1007/s00127-012-0572-z. Epub 2012 Sep 16.


Background: The nature of adolescent sub-syndromal depression has not been investigated in primary care.

Aims: To document frequency, characteristics and 6 month outcome of sub-syndromal depression amongst adolescent primary care attenders.

Method: Primary care attenders (13-18 years) completed depression screening questionnaires (Mood and Feelings Questionnaires) at consultation and at 6 month follow-up. Those screening positive were interviewed with the K-SADS. Sub-syndromal depression was defined as high levels of depressive symptoms in the absence of depressive disorder.

Results: Two hundred and seventy four questionnaires were completed at consultation: the estimated rate of sub-syndromal depression was 25 %. These young people were clinically intermediary between those without depressive symptoms and those with depressive disorder; at 6-months follow-up 57 % had persistent depressive symptoms and 12 % had developed a depressive disorder. Negative life events during the follow-up period and a positive family history of depression were the strongest predictors of symptom persistence and the development of depressive disorder, respectively.

Conclusion: Sub-syndromal depression is common and persistent, in adolescent primary care attenders and it deserves attention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Depression / epidemiology*
  • Depression / psychology
  • Episode of Care
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Life Change Events
  • London / epidemiology
  • Male
  • Mass Screening
  • Multivariate Analysis
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Proportional Hazards Models
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires