Predicting Depression: Is Subthreshold Depression a Precursor to Major Depressive Disorder?
Diagnosing depression requires great attention to detail. While depressive symptoms are similar, the severity and the length of time the symptoms persist determine what type of depression a person may suffer from.
According to the diagnostic criteria for Major Depressive Disorder, patients must show at least 5 out of 9 of these symptoms, present nearly every day:
- Depressive mood or irritability
- Decreased interest or pleasure
- Significant weight change (5%) or change in appetite
- Change in sleep
- Change in activity
- Fatigue or loss of energy
- Feelings of guilt/worthlessness
- Loss of concentration
How Subthreshold Depression is Different
Subthreshold Depression doesn’t meet the criteria for Major Depressive Disorder. Patients who have subthreshold depression suffer from a cluster of depressive symptoms, meaning they suffer from 2-4 symptoms of depression for at least two weeks or longer, one of those symptoms being depressed mood or anhedonia (loss of interest in activities that formerly brought pleasure or satisfaction). Although subthreshold depression does not classify as a major depressive state, researchers are working on ways to identify and treat it early as it could lead to major depression (10-20% of subthreshold depression cases lead to major depression). Researchers say that subthreshold depression is not a different type of depression, but rather a precursor to the development of major depression.
Researchers have begun creating subdivisions of subthreshold depression, one major subdivision being Subsyndromal Symptomatic Depression or SSD. SSD is where patients have more than two depressive symptoms, but unlike subthreshold depression proper, depressive mood or anhedonia are not present. For a depressive state to classify as SSD symptoms must be present for more than two weeks, and be associated with social dysfunction.
These different classifications of depression help physicians develop the best plan of action for treatment for their patients. Knowing where they fall on the scale of depressive disorders helps determine whether immediate medical treatment is needed, or if other options for managing the disorder can be explored.
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