Jeffrey M. Lyness, MD; Moonseong Heo, PhD; Catherine J. Datto, MD, MS; Thomas R. Ten Have, PhD; Ira R. Katz, MD, PhD; Rebecca Drayer, MD; Charles F. Reynolds, MD; George S. Alexopoulos, MD; Martha L. Bruce, PhD, MPH*
Grant Support: PROSPECT is a collaborative research study funded by the National Institute of Mental Health. The 3 collaborative sites include the Advanced Centers for Intervention and Services Research of Cornell University (R01 MH59366, P30 MH68638), the University of Pennsylvania (R01 MH59380, P30 MH52129), and the University of Pittsburgh (R01 MH59381, P30 MH52247, P30 MH71944). Additional small grants came from Forest Laboratories and the John D. Hartford Foundation. Dr. Bruce is a recipient of National Institute of Mental Health grant NIMH K02 MH01634, and Dr. Lyness is supported by NIMH R01 MH61429 and K24 MH71509 from the Institute.
Potential Financial Conflicts of Interest: Consultancies: G.S. Alexopoulos (Forest Pharmaceuticals); Honoraria: G.S. Alexopoulos (Forest Pharmaceuticals, Janssen, Cephalon, Pfizer Inc., Bristol-Myers Squibb, Eli Lilly Inc., Glaxo Wellcome); Grants received: G.S. Alexopoulos (Forest Pharmaceuticals, Cephalon); Other (tablets and placebos): C.F. Reynolds III (Forest Pharmaceuticals, GlaxoSmithKline, Pfizer Inc., Eli Lilly Inc.).
Requests for Single Reprints: Jeffrey M. Lyness, MD, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642; e-mail, Jeffrey_Lyness@urmc.rochester.edu.
Current Author Addresses: Dr. Lyness: Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642.
Drs. Heo, Alexopoulos, and Bruce: New York Hospital Cornell Medical Center, 21 Bloomingdale Road, White Plains, NY 10605.
Drs. Datto, Ten Have, and Katz: University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104.
Drs. Drayer and Reynolds: Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213.
Author Contributions: Conception and design: J.M. Lyness, T.R.Ten Have, I.R. Katz, C.F. Reynolds III, G.S. Alexopoulos, M.L. Bruce.
Analysis and interpretation of the data: J.M. Lyness, M. Heo, C.J. Datto, R. Drayer, I.R. Katz, M.L. Bruce.
Drafting of the article: J.M. Lyness, C.J. Datto, C.F. Reynolds III, G.S. Alexopoulos, M.L. Bruce.
Critical revision of the article for important intellectual content: J.M. Lyness, M. Heo, T.R.Ten Have, C.J. Datto, R. Drayer, C.F. Reynolds III, G.S. Alexopoulos, I.R. Katz, M.L. Bruce.
Final approval of the article: J.M. Lyness, M. Heo, T.R.Ten Have, C.J. Datto, C.F. Reynolds III, G.S. Alexopoulos, I.R. Katz, M.L. Bruce.
Provision of study materials or patients: C.F. Reynolds III, G.S. Alexopoulos, I.R. Katz, M.L. Bruce.
Statistical expertise: T.R.Ten Have, M. Heo.
Obtaining of funding: T.R.Ten Have, C.F. Reynolds III, G.S. Alexopoulos, I.R. Katz, M.L. Bruce.
Administrative, technical, or logistic support: I.R. Katz, M.L. Bruce.
Collection and assembly of data: C.J. Datto, G.S. Alexopoulos, I.R. Katz, M.L. Bruce.
Lyness J., Heo M., Datto C., Ten Have T., Katz I., Drayer R., Reynolds C., Alexopoulos G., Bruce M.; Outcomes of Minor and Subsyndromal Depression among Elderly Patients in Primary Care Settings. Ann Intern Med. 2006;144:496-504. doi: 10.7326/0003-4819-144-7-200604040-00008
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Published: Ann Intern Med. 2006;144(7):496-504.
Depressive conditions in later life are a major public health problem because they are common and associated with considerable morbidity (1-10). However, most elderly persons who have clinically significant depressive symptoms do not meet diagnostic criteria for major depression or dysthymic disorder (4, 7, 11). Terms such as minor, subsyndromal, or subthreshold depression have been used to describe such “sub-major” depressive conditions. In younger adults, minor and subsyndromal depression are associated with greater cumulative functional disability than major depression (12); they probably exist along a dimensional spectrum of symptomatic severity (11, 13, 14), sometimes (but not always) representing a prodromal or residual phase of a major mood disorder.
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