Comprehensive Psychiatry
Volume 41, Issue 2, Supplement 1 , Pages 14-18, March 2000

Public health consequences of different thresholds for the diagnosis of mental disorders

  • Kathryn M. Magruder

      Affiliations

    • From the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; and the National Institute of Mental Health, Rockville, MD, USA.
    • Corresponding Author InformationAddress reprint requests to Kathryn M. Magruder M.P.H., Ph.D., Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Post Office 250861, Charleston, SC 29425.
  • ,
  • Gerald E. Calderone

      Affiliations

    • From the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; and the National Institute of Mental Health, Rockville, MD, USA.

The acceptance of subthreshold disorders in psychiatry is a controversial topic with multiple implications for public health policy. Using subthreshold depression as an example, we provide documentation based on data from epidemiologic and clinical studies suggesting that subthreshold conditions are not uncommon, there is significant associated disability (with significant societal costs), and the course of illness often leads to the development of the full-blown disorder. The potential societal benefits of developing and testing low-cost, low-risk, and nontraditional treatments are considered. The recommendations are to match treatment intensity and cost with severity level in a staged approach.

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PII: S0010-440X(00)80003-6

Comprehensive Psychiatry
Volume 41, Issue 2, Supplement 1 , Pages 14-18, March 2000