Minor depression variously defined has been associated
with impairment similar to that of major depression, including
impaired physical functioning, disability days, poorer selfrated
health, use of psychotropic medications, perceived low
social support, female gender, and being unmarried.14,15 Studies
have attempted defining this construct with suggested
cut-off scores on depression rating scales, with one study
suggesting a score of 16 on the Center for Epidemiologic
Studies Depression Scale (CES-D) but not meeting criteria
for major depression,14 and another suggesting a score of 11 to
15 on the CES-D.15 Another variant described in the elderly
cohort is “depression without sadness,” a presentation of depressive
symptoms without actual sadness or low mood.16
There are several additional subtypes suggested, and a future
challenge for the field of geriatric psychiatry is to develop an
agreed upon definition of what constitutes clinically signifi-
cant subthreshold depression that warrants treatment.