[Subthreshold psychological disorders]

Abstract

Subthreshold psychic disorders are mild, masked, atypical, or intense but brief psychopathological syndromes below the threshold of standardized diagnoses. They indicate beginning, intermittent, or residual states of well-known psychic disorders or ("comorbid") syndromes associated to other psychic or somatic disorders or possibly partially morbid states by themselves. At least the subthreshold depressions and anxiety disorders are more than twice as frequent as specified diagnosable psychic disorders and have serious consequences with regard to both individual suffering and cost. Primarily they are a problem for primary medical care. It is mainly up to the general practitioner to recognise beginning or residual psychic disorders underlying disturbed well-being or uneasiness in order to treat them preventively or curatively or to co-treat such comorbid states in somatic diseases. Open questions of research and possible consequences for health policy are discussed.