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• W2016681344 abstract "Editorials4 April 2006Minor Depression: Midway between Major Depression and EuthymiaKurt Kroenke, MDKurt Kroenke, MDFrom Regenstrief Institute, Inc., Indianapolis, IN 46202.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-7-200604040-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When it comes to mood disorders, major depression has dominated the headlines. Diagnosis of major depression requires that the patient have at least 5 of 9 criterion symptoms (1 of which must be depressed mood or anhedonia) nearly every day for 2 or more weeks. Attracting somewhat less attention, dysthymia is a chronic disorder that manifests as depressive symptoms that persist more days than not for several years. Diagnosis of dysthymia does not require at least 5 symptoms, unlike major depression. Minor depression has been the Cinderella of the 3 conditions: The diagnosis requires neither meeting the symptom threshold of ...References1. Pincus HA, Davis WW, McQueen LE. “Subthreshold” mental disorders. A review and synthesis of studies on minor depression and other “brand names”. Br J Psychiatry. 1999;174:288-96. [PMID: 10533546] CrossrefMedlineGoogle Scholar2. Cuijpers P, Smit F. Subthreshold depression as a risk indicator for major depressive disorder: a systematic review of prospective studies. Acta Psychiatr Scand. 2004;109:325-31. [PMID: 15049768] CrossrefMedlineGoogle Scholar3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994. Google Scholar4. Ackermann RT, Williams JW. Rational treatment choices for non-major depressions in primary care: an evidence-based review. J Gen Intern Med. 2002;17:293-301. [PMID: 11972726] CrossrefMedlineGoogle Scholar5. Oxman TE, Sengupta A. Treatment of minor depression. Am J Geriatr Psychiatry. 2002;10:256-64. [PMID: 11994212] CrossrefMedlineGoogle Scholar6. Beekman AT, Geerlings SW, Deeg DJ, Smit JH, Schoevers RS, de Beurs E, et al. The natural history of late-life depression: a 6-year prospective study in the community. Arch Gen Psychiatry. 2002;59:605-11. [PMID: 12090813] CrossrefMedlineGoogle Scholar7. Penninx BW, Geerlings SW, Deeg DJ, van Eijk JT, van Tilburg W, Beekman AT. Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry. 1999;56:889-95. [PMID: 10530630] CrossrefMedlineGoogle Scholar8. Lyness JM, Heo M, Datto CJ, Ten Have TR, Katz IR, Drayer R, et al. Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Ann Intern Med. 2006;144:496-504. LinkGoogle Scholar9. Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch Gen Psychiatry. 2005;62:66-72. [PMID: 15630074] CrossrefMedlineGoogle Scholar10. Angst J, Merikangas K. The depressive spectrum: diagnostic classification and course. J Affect Disord. 1997;45:31-9; discussion 39-40. [PMID: 9268773] Google Scholar11. Kessler RC, Zhao S, Blazer DG, Swartz M. Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord. 1997;45:19-30. [PMID: 9268772] CrossrefMedlineGoogle Scholar12. Lewinsohn PM, Klein DN, Durbin EC, Seeley JR, Rohde P. Family study of subthreshold depressive symptoms: risk factor for MDD? J Affect Disord. 2003;77:149-57. [PMID: 14607392] CrossrefMedlineGoogle Scholar13. Kumar A, Jin Z, Bilker W, Udupa J, Gottlieb G. Late-onset minor and major depression: early evidence for common neuroanatomical substrates detected by using MRI. Proc Natl Acad Sci U S A. 1998;95:7654-8. [PMID: 9636205] CrossrefMedlineGoogle Scholar14. Schulberg HC, Raue PJ, Rollman BL. The effectiveness of psychotherapy in treating depressive disorders in primary care practice: clinical and cost perspectives. Gen Hosp Psychiatry. 2002;24:203-12. [PMID: 12100831] CrossrefMedlineGoogle Scholar15. Oxman TE, Barrett JE, Sengupta A, Katon W, Williams JW, Frank E, et al. Status of minor depression or dysthymia in primary care following a randomized, controlled treatment. Gen Hosp Psychiatry. 2001;23:301-10. [PMID: 11738460] CrossrefMedlineGoogle Scholar16. Brody DS, Khaliq AA, Thompson TL. Patients' perspectives on the management of emotional distress in primary care settings. J Gen Intern Med. 1997;12:403-6. [PMID: 9229277] CrossrefMedlineGoogle Scholar17. Unutzer J, Katon W, Callahan CM, Williams JW, Hunkeler E, Harpole L, et al. Collaborative care management of late-life depression in the primary care setting: a randomized, controlled trial. JAMA. 2002;288:2836-45. [PMID: 12472325] CrossrefMedlineGoogle Scholar18. Bruce ML, Ten Have TR, Reynolds CF, Katz II, Schulberg HC, Mulsant BH, et al. Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized, controlled trial. JAMA. 2004;291:1081-91. [PMID: 14996777] CrossrefMedlineGoogle Scholar19. Rapaport MH, Judd LL, Schettler PJ, Yonkers KA, Thase ME, Kupfer DJ, et al. A descriptive analysis of minor depression. Am J Psychiatry. 2002;159:637-43. [PMID: 11925303] CrossrefMedlineGoogle Scholar20. Wells K, Sherbourne C, Duan N, Unutzer J, Miranda J, Schoenbaum M, et al. Quality improvement for depression in primary care: do patients with subthreshold depression benefit in the long run? Am J Psychiatry. 2005;162:1149-57. [PMID: 15930064] CrossrefMedlineGoogle Scholar21. Ciechanowski P, Wagner E, Schmaling K, Schwartz S, Williams B, Diehr P, et al. Community-integrated home-based depression treatment in older adults: a randomized, controlled trial. JAMA. 2004;291:1569-77. [PMID: 15069044] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Regenstrief Institute, Inc., Indianapolis, IN 46202.Disclosures: Honoraria and grants received: Eli Lilly Inc., Pfizer Inc., Wyeth.Corresponding Author: Kurt Kroenke, MD, Regenstrief Institute, Inc., RG-6, 1050 Wishard Boulevard, Indianapolis, IN 46202; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOutcomes of Minor and Subsyndromal Depression among Elderly Patients in Primary Care Settings Jeffrey M. Lyness , Moonseong Heo , Catherine J. Datto , Thomas R. Ten Have , Ira R. Katz , Rebecca Drayer , Charles F. Reynolds III , George S. Alexopoulos , and Martha L. Bruce Metrics Cited ByPeer Companionship for Mental Health of Older Adults in Primary Care: A Pragmatic, Nonblinded, Parallel-Group, Randomized Controlled TrialTrends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims dataFeasibility and preliminary efficacy of a smartphone application intervention for subthreshold depressionReevaluating the prevalence and diagnostic subtypes of depressive disorders in epilepsyShould criteria be specified for depressive disorder not otherwise specified?How Should Primary Care Doctors Select Which Antidepressants to Administer?A study of the diagnostic accuracy of the PHQ-9 in primary care elderlyLiving in the DoldrumsGlucocorticoid receptor gene polymorphisms and childhood adversity are associated with depression: New evidence for a gene-environment interactionThe impact of clinical significance criteria on subthreshold depression prevalence ratesPrevalence of mental disorders based on general population surveysLas dificultades para un diagnóstico preciso de la depresión y sus consecuencias en la práctica asistencialProdromal stage of major depression 4 April 2006Volume 144, Issue 7Page: 528-530KeywordsAntidepressantsDepressionDysthmiaElderlyMedical risk factorsMood disordersPatientsProblem solvingPsychiatry and mental healthYoung adults ePublished: 4 April 2006 Issue Published: 4 April 2006 CopyrightCopyright © 2006 by American College of Physicians. 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