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

Abstract

The nature of adolescent sub-syndromal depression has not been investigated in primary care. To document frequency, characteristics and 6 month outcome of sub-syndromal depression amongst adolescent primary care attenders. 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. 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. Sub-syndromal depression is common and persistent, in adolescent primary care attenders and it deserves attention.