Clinical Features and Functioning of Patients with Minor DepressionHowland R.H. · Schettler P.J. · Rapaport M.H. · Mischoulon D. · Schneider T. · Fasiczka A. · Delrahiem K. · Maddux R. · Lightfoot M. · Nierenberg A.A.
aDepartment of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pa., bDepartment of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, Calif., and cDepartment of Psychiatry, Massachusetts General Hospital, Boston, Mass., USA
Background: The two essential features of minor depression are that it has fewer symptoms than major depression and that it is less chronic than dysthymia. This study describes the clinical features and functioning of outpatients with minor depression. Methods: Subjects with minor depression (with and without a prior history of major depression) were recruited through clinical referrals and community advertising. Assessments included the Structured Clinical Interview for DSM-IV (SCID), the 17-item Hamilton Rating Scale for Depression (HAM-D), the Inventory of Depressive Symptomatology-Self Report (IDS-SR) and Clinician Rated (IDS-C) scales, the Global Assessment of Functioning (GAF) scale, the Medical Outcomes Study 36-item Short-Form scale (MOS), and the Clinical Global Impressions Severity Scale (CGI). Data from previously published studies of major depression, minor depression, and normal controls were compared to our data set. Results: Minor depression is characterized primarily by mood and cognitive symptoms rather than vegetative symptoms; the functional impairment associated with minor depression is as severe as for major depression in several areas; minor depression occurs either independently of major depression or as a stage of illness during the long-term course of major depression, and minor depression patients with and without a history of major depression have similar levels of depressive severity and functional impairment. Conclusions: These findings support the notion that minor depression is an important clinical entity that fits within the larger spectrum of depressive disorders.