Minor depression: risk profiles, functional disability, health care use and risk of developing major depression

Background: minor depression has been found to affect quality of life, result in a increased service utilization, and lead to an increased risk of developing a major depression. In this study we examine risk profiles, functional disability, service utilization and the risk of developing major depression in minor depression. Methods: a random sample of the Dutch population (n=7076) was interviewed at baseline and 1 and 3 years later (response rate: 69.7%). Five categories of depression status were defined: major depression with seven to nine symptoms; with five or six symptoms; minor depression; one key symptom only; no depressive symptoms. Independent variables included: functional disability; care utilization; sociodemographic characteristics. Results: functional disability was more pronounced in more severe categories of depression. Health care use was also found to be most intensive for more severe depression. The risk of developing major depression in subjects with minor depression was found to be 8.0% after 2 years. Limitations: there had already been some attrition from the study when minor depression was measured. A definition of minor depression which approached the DSM-IV definition. Absence of homeless individuals in the dataset. Conclusions: depressive disorders seem to exist on a continuum, rather than in separate categories. Subjects with minor depression make less use of professional services than subjects with major depression, but because minor depression is more prevalent than major depression, the absolute number of subjects with minor depression receiving professional help is considerable.