Citation

Balazs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, Apter A, Bobes J, Brunner R, Cosman D, Cotter P, Haring C, Iosue M, Kaess M, Kahn JP, Keeley H, Marusic D, Postuvan V, Resch F, Saiz PA, Sisask M, Snir A, Tubiana A, Värnik A, Sarchiapone M, Wasserman D. J. Child Psychol. Psychiatry 2013; 54(6): 670-677.

Affiliation

Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary Institute of Psychology, Eötvös Loránd University, Budapest, Hungary Semmelweis University, School of Ph.D. Studies, Budapest, Hungary Heim Pál Paediatric Hospital, Budapest, Hungary Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, USA Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden Medicine and Health Science Department, University of Molise, Campobasso, Italy Feinberg Child Study Center, Schneider Children's Medical Center, Tel Aviv University, Tel Aviv, Israel Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania National Suicide Research Foundation, Cork, Ireland Research Division for Mental Health, University for Medical Information Technology (UMIT), Innsbruck, Austria Orygen Youth Health Research Centre, The University of Melbourne, Melbourne, Vic., Australia Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, NANCY-France Mental Health Department, PINT, University of Primorska, Primorska, Slovenia Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, Tallinn, Estonia.

Copyright

(Copyright © 2013, John Wiley and Sons)

DOI

10.1111/jcpp.12016

PMID

23330982

Abstract

Background:  Subthreshold-depression and anxiety have been associated with significant impairments in adults. This study investigates the characteristics of adolescent subthreshold-depression and anxiety with a focus on suicidality, using both categorical and dimensional diagnostic models. Methods:  Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, comprising 12,395 adolescents from 11 countries. Based on self-report, including Beck Depression Inventory-II (BDI-II), Zung Self-Rating Anxiety Scale (SAS), Strengths and Difficulties Questionnaire (SDQ) and Paykel Suicide Scale (PSS) were administered to students. Based on BDI-II, adolescents were divided into three groups: nondepressed, subthreshold-depressed and depressed; based on the SAS, they were divided into nonanxiety, subthreshold-anxiety and anxiety groups. Analyses of Covariance were conducted on SDQ scores to explore psychopathology of the defined groups. Logistic regression analyses were conducted to explore the relationships between functional impairments, suicidality and subthreshold and full syndromes. Results:  Thirty-two percent of the adolescents were subthreshold-anxious and 5.8% anxious, 29.2% subthreshold-depressed and 10.5% depressed, with high comorbidity. Mean scores of SDQ of subthreshold-depressed/anxious were significantly higher than the mean scores of the nondepressed/nonanxious groups and significantly lower than those of the depressed/anxious groups. Both subthreshold and threshold-anxiety and depression were related to functional impairment and suicidality. Conclusions:  Subthreshold-depression and subthreshold-anxiety are associated with an increased burden of disease and suicide risk. These results highlight the importance of early identification of adolescent subthreshold-depression and anxiety to minimize suicide. Incorporating these subthreshold disorders into a diagnosis could provide a bridge between categorical and dimensional diagnostic models.

Language: en