Examining minor and major depression in adolescents

Research has shown that a large proportion of adolescents with symptoms of depression and substantial distress or impairment fail to meet the diagnostic criteria for a major depressive disorder (MDD). However, many of these undiagnosed adolescents may meet criteria for a residual category of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR), Depressive Disorder Not Otherwise Specified. Minor Depression (mDEP), an example of one of these categories, allows the inclusion of sub-threshold cases that fall below the diagnostic criteria of the five symptoms required for MDD. Minor depression in adolescence is important because it is significantly related to MDD in adulthood. The present study examines a number of risk factors, functional impairment, comorbidity and service utilization patterns associated with depression in community adolescents who met the DSM-IV criteria for mDEP and compares their profile to adolescents who met the criteria for MDD.

Puerto Rican adolescents 11 to 17 years old were selected from an island-wide probability household sample of children ranging in age from 4 to 17. The Diagnostic Interview Schedule in Spanish (DISC IV), together with a structured protocol of risks and protective factors, and service utilization questionnaires were administered to primary caretakers and their children.

Our findings indicate that youngsters with mDEP had significant impairment and used more mental health services than those with major depression. In addition, adolescents with mDEP had similar outcomes when compared to those meeting full criteria for MDD in terms of psychosocial correlates and comorbidity.

The results, although not definitive, suggest a need for further research in order to determine the validity of the present DSM IV diagnostic criteria for mDEP in adolescents.