Back to Journals » Neuropsychiatric Disease and Treatment » Volume 15

Subthreshold Depression Needs A Prime Time In Old Age Psychiatry? A Narrative Review Of Current Evidence

Authors Biella MM, Borges MK, Strauss J, Mauer S, Martinelli JE, Aprahamian I

Received 18 July 2019

Accepted for publication 6 September 2019

Published 23 September 2019 Volume 2019:15 Pages 2763—2772

DOI https://doi.org/10.2147/NDT.S223640

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Nicola Ludin

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Marina Maria Biella,1 Marcus Kiiti Borges,1 Jason Strauss,2 Sivan Mauer,3 José Eduardo Martinelli,4 Ivan Aprahamian1,4

1Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; 2Geriatric Psychiatry, Cambridge Health Alliance, Harvard Medical School, Boston, MA, USA; 3Department of Psychiatry, Tufts Medical Center, Tufts University Scholl of Medicine, Boston, MA, USA; 4Geriatrics & Psychiatry Division, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil

Correspondence: Ivan Aprahamian
Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Internal Medicine Department, Faculty of Medicine of Jundiaí, Jundiaí, Brazil
Email ivan.aprahamian@gmail.com

Abstract: This study aims to carry out a narrative review, aiming to update the literature on subsyndromic depression (SD), which is the most prevalent depressive disorder in older adults, and no formal guidelines or consensus are dedicated to this topic. We carried out an electronic search for articles on SD. Relevant articles were retrieved from Pubmed, EMBASE and Web of Science using the search terms “subthreshold depression,” “prevalence,” “treatment” and “older adults” in several combinations. Original articles in English were included from inception to 1st March 2019. No clear consensus exists in the literature on its nosologic classification, diagnostic tools, causes, course, outcomes or management. SD diagnosis should base in depressive symptoms scales and DSM criteria. Treatment relies mainly on collaborative care and psychotherapy. SD is relevant in clinical practice and research in geriatric psychiatry. Given the negative outcomes and potential benefits of treatment, we recommend brief psychotherapy as first-line treatment and use of psychotropic agents in cases with greater severity and/or functional impairment in association with psychotherapy. SD can precede major depressive disorder, but it also may consist of a primary depressive disorder in older adults. Furthermore, adequate treatment of SD can prevent or reduce negative outcomes associated with depressive symptoms such as worsening of clinical comorbidities, loss of functionality, increased demand for health services, and increased mortality.

Keywords: subthreshold depression, prevalence, treatment, depressive symptoms, older adults


Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]