SOCIOECONOMIC BURDEN OF SUBSYNDROMAL DEPRESSIVE SYMPTOMS AND MAJOR DEPRESSION IN A SAMPLE OF THE GENERAL-POPULATION

Objective: The authors' good was to evaluate the association between i mpairment in daily function and subsyndromal depressive symptoms as we ll as major depression to determine the economic and societal signific ance of these conditions. Method: Using 12-month prevalence data gathe red by the National Institute of Mental Health (NIMH) Epidemiologic Ca tchment Area Program (ECA), based on responses to the NIMH Diagnostic Interview Schedule, the authors divided the 2,393 subjects from the Lo s Angeles ECA site into three groups: subjects with subsyndromal depre ssive symptoms (N=270), major depression (N=102), and no depressive di sorder or symptoms (N=2,021). The groups were compared on 10 domains o f functional outcome and well-being. Results: Significantly more subje cts with depressive symptoms than subjects who had no disorder reporte d high levels of household strain, social irritability, and financial strain as well as limitations in physical or job functioning, restrict ed activity days, bed days, and poor health status. Significantly more subjects with major depression than subjects with no disorder reporte d major financial losses, bed days, high levels of financial strain, l imitations in physical or job functioning, and poor health status. Exc ept for lower self-ratings of health status, no significant difference were found between subjects with subsyndromal symptoms and those with major depression. Conclusions: Significantly more people with subsynd romal depressive symptoms or major depression reported impairment in e ight of 10 functional domains than did subjects with no disorder. The high 1-year prevalence of subsyndromal depressive symptoms, combined w ith the associated functional impairment, emphasizes the clinical and public health importance and need for additional investigations into t hese symptoms.