Objective. To assess the ability of screening instruments to detect subthreshold depression or subthreshold anxiety and to make suggestions for the improvement of instrument performance.
Design. Group deยฎnition relied on the presence or absence of major psychiatric disorders or of subthreshold disorders (Composite International Diagnostic Interview).
Setting. A community-based study in Germany.
Participants. The total sample comprised 274 subjects over 60 years of age; 57 subjects suered from acute subthreshold depression, 26 subjects suered from acute subthreshold anxiety, 173 subjects were deยฎned as being healthy (ie no acute or lifetime major psychiatric disorder, no acute subthreshold disorder).
Measures. The short version of the General Health Questionnaire (GHQ-12), the Center for Epidemiologic StudiesรDepression Scale (CES-D), the Structured Interview for the Diagnosis of Dementia of the Alzheimer-type, Multiinfarct Dementia and Dementias of other Etiology (SIDAM) for cognitive impairment.
Results. Subjects with subthreshold disorders scored higher on the CES-D and the GHQ-12 than healthy individuals. The most distinct increase was observed in the CES-D score of subjects with subthreshold anxiety. The CES-D factor for the presence of somatic/vegetative symptoms performed slightly better compared to the other CES-D factors.
Conclusions. The CES-D moderately detected subthreshold anxiety. Subthreshold depression could not be eciently detected by either questionnaire. The combination of items indicating the presence of somatic symptoms and depressive aect could improve instrument performance when screening for subthreshold anxiety but not for subthreshold depression.