28 Nov Dramatic Increase in Subthreshold Psychiatric Diagnoses In Young People

Medicalresearch.com with:
Daniel Safer MD
Department of Psychiatry
Johns Hopkins University School of Medicine
Baltimore, Maryland

Medical Research: What is the nature of this study?

Dr. Safer: A large national sample of annual physician office-based visits by youth (aged 2-19) covering 12 years (1999-2010), focusing on trends in psychiatric DSM-IV diagnoses, with psychiatric diagnostic data analyzed proportionally comparing diagnoses that were subthreshold (not otherwise specified) with those that met full diagnostic criteria.

Medical Research: What are the main findings?

Dr. Safer: Subthreshold diagnoses for mood disorders, anxiety disorders, bipolar disorders and depressive disorders in youth visits increased more proportionally over the 12 year study period compared to diagnostic visits meeting full criteria.

Consequences:

1) Over 50% of mood, anxiety, bipolar and depressive disorders in youth diagnosed during community physician outpatient visits are now subthreshhold.

2) Subthreshold diagnoses are less reliable than full criteria diagnoses and this constitutes a problem for detailed research.

3) Psychiatric medication treatment for subthreshold diagnoses are off-label; that is, unlike many full criteria diagnoses they have not received an FDA indication for medication treatment.

4) Subthreshold psychiatric diagnoses are expanding proportionally more than full criteria diagnoses and this frustrates the hope in DSM-5 that dimensional full criteria psychiatric diagnoses with become the dominant diagnostic method.

Medical Research: What future research do you recommend as a result of this report?

Dr. Safer: Future research should ascertain if this diagnostic trend also exists for adults and to what degree the trend alters the community psychotropic medication patterns.

Citation:

Last Updated on November 28, 2014 by Marie Benz MD FAAD