Journal of Affective Disorders
Volume 122, Issue 1 , Pages 96-101 , April 2010

Minor change in the diagnostic threshold leads into major alteration in the prevalence estimate of depression

  • Linnea Karlsson

      Affiliations

    • National Institute for Health and Welfare, Department for Mental Health and Services for Substance Abuse, Helsinki, Finland
    • Turku University Central Hospital, Departments of Child and Adolescent Psychiatry, Turku, Finland
    • Corresponding Author InformationCorresponding author. Lehmustie 12 b, 20720 Turku, Finland. Tel.: +358 40 744 5052; fax: +358 9 4744 8788.
    • ,
  • Mauri Marttunen

      Affiliations

    • National Institute for Health and Welfare, Department for Mental Health and Services for Substance Abuse, Helsinki, Finland
    • University of Helsinki and Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Hasse Karlsson

      Affiliations

    • University of Helsinki, Department of Psychiatry, Helsinki, Finland
    • ,
  • Jaakko Kaprio

      Affiliations

    • National Institute for Health and Welfare, Department for Mental Health and Services for Substance Abuse, Helsinki, Finland
    • University of Helsinki, Department of Public Health, Helsinki, Finland
    • Institute of Molecular Medicine, Helsinki, Finland
    • ,
  • Aro Hillevi

      Affiliations

    • National Institute for Health and Welfare, Department for Mental Health and Services for Substance Abuse, Helsinki, Finland

Received 27 February 2009 ,Revised 19 June 2009 ,Accepted 19 June 2009.

References 

  1. Aalto-Setälä T, Haarasilta L, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Aro H, et al. Major depressive episode among young adults: CIDI-SF versus SCAN consensus diagnoses. Psychol. Med. 2002;32:1309–1314
  2. Aalto-Setälä T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lönnqvist J. Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am. J. Psychiatry. 2002;159:1235–1237
  3. American Psychiatric Association (APA), 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). American Psychiatric Association, Washington DC, USA.
  4. Andrews G, Brugha T, Thase ME, Duffy FF, Rucci P, Slade T. Dimensionality and the category of major depressive episode. Int. J. Methods Psychiatr. Res. 2007;16(S1):S41–S51
  5. Andrews G, Peters L, Guzman AM, Bird K. A comparison of two structured diagnostic interviews: CIDI and SCAN. Aus. N. Z. J. Psychiatry. 1995;29:124–132
  6. Anthony JC, Folstein M, Romanoski AJ, Von Korff MR, Nestadt GR, Chanal R, et al. Comparison of the lay diagnostic interview schedule and a standardized psychiatric diagnosis. Arch. Gen. Psychiatry. 1985;42:667–675
  7. Arinen S, Häkkinen U, Klaukka T, Klavus J, Lehtonen R, Aro S. Health and use of health services in Finland. Main findings of the Finnish Health Care Survey 1995/96 and changes from 1987. Helsinki, Finland: Official Statistics of Finland; 1998;
  8. Beals J, Manson SM, Whiteshell NR, Mitchell CM, Novins DK, Simpson S, et al. Prevalence of major depressive episode in two American Indian reservation populations: unexpected findings with a structured interview. Am. J. Psychiatry. 2005;162:1713–1722
  9. Bjerkestet O, Nordahl HM, Larsson S, Dahl AA, Linaker O. A 4-year follow-up study of syndromal and sub-syndromal anxiety and depression symptoms in the general population: the HUNT study. Soc. Psychiatry Psychiatr Epidemiol. 2008;43:192–1999Electronic publication 2007 Dec 6
  10. Blazer DG, Kessler RC, McGonagle KA, Swatrz MS. The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am. J. Psychiatry. 1994;151:979–986
  11. Brugha TS, Bebbington PE, Jenkins R. A difference that matters: comparisons of structured and semi-structured psychiatric diagnostic interviews in the general population. Psychol. Med. 1999;29:1013–1020
  12. Compton WM, Conway KP, Stinson FS, Grant BF. Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991–1992 and 2001–2002. Am. J. Psychiatry. 2006;163:2141–2147
  13. Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y. Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981–2004. Acta. Psychiatr. Scand. 2007;116:182–188
  14. Fava GA. The intellectual crisis of psychiatric research. Psychother. Psychosom. 2006;75:202–208
  15. Frances A. Problems in defining clinical significance in epidemiological studies. Arch. Gen. Psychiatry. 1998;55:119
  16. Spitzer RL. Diagnosis and need for treatment are not the same. Arch. Gen. Psychiatry. 1998;55:120
  17. Helzer JE, Robins LN, McEvoy LT, Spitznagel EL, Stoltzman RK, Farmer A, et al. A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population. Arch. Gen. Psychiatry. 1985;42:657–666
  18. Haarasilta L, Marttunen M, Kaprio J, Aro H. The 12-month prevalence and characteristics of major depressive episode in a representative nationwide sample of adolescents and young adults. Psychol. Med. 2001;31:1169–1179
  19. Hämäläinen J, Isometsä E, Laukkala T, Kaprio J, Poikolainen K, Heikkinen M, et al. Use of health services for major depressive episode in Finland. J. Affect. Disord. 2004;79:105–112
  20. Judd LL, Paulus MP, Wells KB, Rapaport MH. Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am. J. Psychiatry. 1996;153:1411–1417
  21. Kennedy N, Abbott R, Paykel ES. Longitudinal syndromal and sub-syndromal symptoms after severe depression: 10-year follow-up study. Br. J. Psychiatry. 2004;184:330–336
  22. Kessler RC, Wittchen HU, Abelson JM, McGonagle K, Schwarz N, Kendler KS, et al. Methodological studies of the composite international diagnostic interview in the US national comorbidity survey. Int. J. Method. Psychiatr. Res. 1998;7:33–55
  23. Kessler RC, Andrews G, Mroczek D, Üstün B, Wittchen HU. The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF). Int. J. Method. Psychiatr. Res. 1998;7:171–185
  24. Lindeman S, Hämäläinen J, Isometsä E, Kaprio J, Poikolainen K, Heikkinen M, et al. The 12-month prevalence and risk factors for major depressive episode in Finland: representative sample of 5993 adults. Acta. Psychiatr. Scand. 2000;102:178–184
  25. McLeod JD, Turnbull JE, Kessler RC, Abelson JM. Sources of discrepancy in the comparison of a lay-administered diagnostic instrument with clinical diagnosis. J. Psychiatr. Res. 1990;31:1451–1459
  26. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States. Arch. Gen. Psychiatry. 2002;59:115–123
  27. Parker G. Beyond major depression. Psychol. Med. 2005;35:467–474
  28. Paykel ES. Mood disorders: review of current diagnostic systems. Psychopathology. 2002;35:94–99
  29. Pine DS, Cohen E, Cohen P, Gurley D, Brook J. Adolescent depressive symptoms as predictors of adults depression: moodiness or mood disorder?. Am. J. Psychiatry. 1999;156:133–135
  30. Regier DA, Kaelber CT, Rae DS, Farmer ME, Knauper B, Kessler RC, et al. Limitations of diagnostic criteria and assessment instruments for mental disorders. Arch. Gen. Psychiatry. 1998;55:109–115
  31. Schuman H, Scott J. Problems in the use of survey questions to measure public opinion. Science. 1987;236:957–959
  32. Stata Corp. . Stata statistical software: release 9. USA: Stata Corporation; 2006;
  33. Wittchen HU. Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. J. Psychol. Res. 1994;28:57–84
  34. Wittchen HU, Üstün TB, Kessler RC. Diagnosing mental disorders in the community. A difference that matters. Psychol. Med. 1999;29:1021–1027
  35. World Health Organization (WHO), 1992. The ICD-10 classification of mental and behavioral disorders: clinical description and diagnostic guidelines. World Health Organization, Geneva, Switzerland.

PII: S0165-0327(09)00285-7

doi: 10.1016/j.jad.2009.06.025

Journal of Affective Disorders
Volume 122, Issue 1 , Pages 96-101 , April 2010

Article Tools

* Image Usage & Resolution