From depressive symptoms to depressive disorders:the relevance of thresholds

BACKGROUND: Nosological boundaries for depressive disorders as well as the prevalence and impact of 'subsyndromal' depression remain unclear. AIMS: To examine the impact of subsyndromal depressive disorders on health status and to assess if depressive disorders lie on a continuum of severity. METHOD: The sample was composed of randomly selected respondents from the general population in 68 countries from across the world participating in the World Health Organization's World Health Survey. RESULTS: The pattern of risk factors for depressive disorders was consistent across all types of depression (subsyndromal, brief depressive episode and depressive episode): odds ratios for females ranged between 1.49 and 1.80, and for the unemployed from 1.19 to 1.25. All types of depression produced a significant decrement in health status compared with no depression after controlling for demographic variables, income and country. CONCLUSIONS: Subthreshold depressive disorders occur commonly all across the world and are associated with the same risk factors everywhere. They produce significant decrements in health and do not qualitatively differ from full-blown episodes of depression as currently defined, and lie on a continuum with more severe forms of depressive episodes but are distinct from normal mood changes.

Anxiety disorders and depression and risk for drug use disorders across the life course: Sex and ethnic contrasts

The present study examined the linkage between mental (i.e., anxiety disorders and depression) and drug use disorders in a multi-ethnic (i.e., 25% Euro-American, 38% Hispanic/Latino, 33% African American, 4% other) sample of adults (N = 1638, age 18–93 years old). Risk for drug use disorders was examined, while attending to methodological issues of prior research including (1) psychiatric comorbidity, (2) variations in risk associated with sex, ethnicity, and age, and (3) temporal order between mental and drug use disorders. ^ Participants were assessed using the Composite International Diagnostic Interview (CIDI; World Health Organization, 1990). A life history calendar (Freedman et al., 1988) was used to aid the ordering of onsets of all disorders assessed. ^ Preliminary analysis indicated anxiety disorders and depression were significant predictors of drug use disorders, but after controlling for comorbidity and temporal order, anxiety disorders and depression were no longer predictive of drug use disorders. Findings are discussed in terms of their usefulness for prevention and treatment of drug use disorders. ^

Iraqi Birth Defects and the WHO Report

Since the U.S.-led invasion of Iraq in 2003, epidemics of birth defects and cancers are rising in many Iraqi cities. In 2012, the World Health Organization (WHO) and the Iraqi Ministry of Health (MoH) undertook a large-scale epidemiological study to determine the prevalence of birth defects in the Iraqi population. A report which appeared on the WHO website in September 2013, claims that "The rates for spontaneous abortion, stillbirths and congenital birth defects found in the [Iraq] study are consistent with or even lower than international estimates." This article discusses the severe shortcomings of this report and questions its reliability .