Secondary analyses in a subsample (N = 9160) of the National Institute
of Mental Health Epidemiologic Catchment Area Program data base revea
led that 19.6% of the general population reported one or more depressi
ve symptoms in the previous month. One-year prevalence of two or more
depressive symptoms in the general population was 11.8%, a prevalence
figure exceeding the 9.5% 1-year prevalence for all the DSM-III mood d
isorders combined. We have labeled this potential clinical condition a
s subsyndromal symptomatic depression (SSD), defining it as any two or
more simultaneous symptoms of depression, present for most or all of
the time, at least 2 weeks in duration, associated with evidence of so
cial dysfunction, occurring in individuals who do not meet criteria fo
r diagnoses of minor depression, major depression, and/or dysthymia. S
SD has a 1-year prevalence in the general population of 8.4%, two thir
ds of whom are women (63.4%). The most common SSD symptoms reported ar
e insomnia (44.7%), feeling tired out all the time (42.1%), recurrent
thoughts of death (31.0%), trouble concentrating (22.7%), significant
weight gain (18.5%), slowed thinking (15.1%), and hypersomnia (15.1%).
Increased prevalence of disability and welfare benefits was found in
SSD as compared with respondents with no depressive symptoms. SSD repr
esents a significant clinical population not covered by any DSM-III, D
SM-III-R, or DSM-IV mood disorder diagnosis. Since SSD is also associa
ted with significant increases in social dysfunction and disability, w
e feel there is good evidence to conclude that SSD is an unrecognized
clinical condition of considerable public health importance that is de
serving of further characterization and study.