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Author(s): Anamika Modi Jain, M. Jha


Address: Psychometric laboratory, School of Studies in Psychology, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh.

Published In:   Volume - 27,      Issue - 1,     Year - 2021

Cite this article:
Jain, and Jha (2021).Prevalence of Subclinical Depression among College Students: A Review. Journal of Ravishankar University (Part-A: SOCIAL-SCIENCE), 27(1), pp. 16-33.

Prevalence of Subclinical Depression among College Students: A Review

Anamika Modi Jain and Dr. M. Jha

Psychometric laboratory, School of Studies in Psychology, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh.

*Corresponding author:



INTRODUCTION - Early adult stage is the transition from adolescence to young adulthood, presents significant challenges like the chance to manage one’s life and affect more independent roles. A number of them adjust with these challenges and a few couldn’t manage these stressors which can cause the mental health problems. Among these problems depression is very common, and it is very difficult to detect in early stage, which often identified as a minor or subclinical depression.

SD patients were in a mean position between non-depressive and depressive patients with regard to social isolation and physical destruction; women were overrepresented in the depressive and sub-depressive groups” (Schnieder et al. 2000). Study suggests the prevalence rate of subclinical depression was very high, which need urgent attention for identification and treatment. If it is ignored or left untreated long term effect may be appear in the form of major or severe depression.

METHOD - A comprehensive systematic search of published literature and journal articles from Google Scholar, Pub Med, MEDLINE and EBSCO was taken. Search strategy specific to each data repository was used. During initial search 642 titles were retrieved and finally 38 empirical researches were selected based on the inclusion criteria.

RESULT - Total 38 articles were selected, out of 38 approx 36 studies shows the rate of prevalence of Subclinical depression among college students and some studies based on impact and factors associated with subclinical depression. 

CONCLUSION - It is very important that health care providers, counselors, teachers and parents should pay special attention for early detection and treatment of subclinical depressive symptoms in early adults.

KEYWORDS - Subclinical depression (SD), College students, Prevalence, Health care providers.



"Subclinical depression refers to an emotionally negative state which significantly influences level of achievement and quality of life, but which cannot be classified as an illness. Based on the seriousness of the symptoms, it could be measured on different scales of depression as mild or moderate” (Margitics, 2006). “When 4-5 symptoms of depression present continue two weeks with the impairment present in individual functioning, then it is subclinical depression. It is a common condition person falling below the diagnostic threshold experience”, it affect our daily life negatively.

“Depressive syndromes that do not obey with the diagnostic criteria for specific depressive disorders are nominated as 'subclinical' or 'sub-syndromal' depressive syndromes. SD patients were in a mean position between non-depressive and depressive patients with regard to social isolation and physical destruction; women were overrepresented in the depressive and sub-depressive groups” (Schnieder et al. 2000). Regarding subclinical depression, also called sub-threshold depression or sub-syndromal symptomatic depression, between 2 and 5 depressive symptoms were required for the diagnosis and a minimum duration of 2 weeks. Significant destruction associated with sub-threshold depressive conditions, as well as co morbidity with other mental disorders, has been described.

Need for the study:

The world health organization (WHO) defines “depression is a common mental disorder that presents with sad mood, loss of interest or happiness, feeling of guiltiness or low sense of worth, scattered sleep or appetite low energy and reduced attention”. These problems can become constant, repeated and change in to significant disability in a person’s capability to take care of his or her daily responsibilities”. At its bad, depression can direct to suicide, a disastrous casualty linked with the loss of about 850,000 life’s per year. The WHO highlights the occurrence of depression in younger age group (20-25). Based on data NCR-R (National Co-morbidity Survey-Replication), half of all life time cases of mood disorders start at 14 years and three-fourths by 24 years (Kessler, Berglund, Demler, Jin & Walters, 2005). Subclinical Depression (minor or sub threshold depression) have been defined in a wide range of forms, varying on a number of symptoms and duration required. Subclinical Depression in adolescent is a risk factor for further development of clinical depression. However there is a lacuna of research that document subclinical depression among adolescent in India.


The aim of the study find out the prevalence rate of subclinical depression among college students and factors associated with it.


To determine the prevalence of subclinical depression and factors associated with it.


Search strategy methods:

The subclinical depression was selected as the area of interest and a search was conducted on online database. Google scholar, Pub Med, MEDLINE, EBSCO to retrieve quantitative and qualitative research article published from 2003-2020 and the search was confined to only English language. The search terms used “subclinical depression”, minor depression, “sub-threshold depressive symptoms”, sub-threshold depression; “subclinical depressive conditions” sub-syndromal depression and prevalence of depression among college students and those terms were searched both in the title and in the abstract. We included original research, prevalence and associated characteristics of minor and sub-threshold depression in general in both community and primary care settings.


Search strategy:

Factors affecting subclinical depression among college students [All Fields] "Subclinical depression [Mesh] AND "College students" [Mesh]) AND "minor depression" [Mesh]) AND “early Adulthood" [Mesh]) AND "prevalence of depression” [Mesh].

Types of studies:

Qualitative study and Quantitative study, Cross sectional study and longitudinal study.

Type of participants:

 College students / early adult / late adolescents, above residing in rural and urban area.


Rural area, urban area and studying in college and university.  


The narrative review shows that the prevalence of subclinical depression was very common among the college students and late adolescence or early adult stage, which may cause the major depression in next stage of life. And several factors impact on depression among college students which provoke depressive symptoms.

Delivery of Intervention:

This narrative review was predetermined with the exploration of reviews related to the topic “Prevalence of subclinical depression among college students” the search begins with the keywords. Online databases which were used for the exploration of review were Google scholar, Pub Med from the year 2003-2020. The search was confined to only English language other was excluded. Those phrases were searched both within the name and inside the abstract. We protected authentic researches (Observational and epidemiological studies) occurrence and related characteristics of youngster and subclinical depression in younger population in both community and primary health care settings. Bibliography of retrieved papers changed into examined. 642 papers have been considered. 38 studies have been selected as they had been population based research analyzing subclinical depressive (mild and moderate depressive) situations in well known population. The  remaining 602 papers were disqualified because of numerous reasons: the kind of paper; research of the psychometric properties of instruments, records excluded due to exceed limitation of the year, restrict to  particular age ranges, evaluation of interventions (effectiveness of various therapies); studies of the biology of subclinical depressive disorders.



(Table too large to preview. Please view the Table in PDF version of this article.)


The narrative review outcome shows the prevalence of subclinical depression among students studying in different colleges or universities. It reveals that subclinical or minor depression was very common among early adult or college students and there are a variety of variables that influence the severity of depression, including biological, social, psychological, demographical, behavioral and cognitive aspects.

 Summary of findings:

The available literature was refined to get 38 quantitative studies:

·       Out of 38 studies maximum empirical research shows the prevalence rate of subclinical depression along with different level of occurrence of depression.

·       Some longitudinal studies concluded that significant association between minor depression in adolescences and adverse mental health result in adulthood or major/severe depression resulted in adulthood.

·       A few studies concluded that females was vulnerable for depression these studies show the gender effect.

·       Among these several studies based on the socio-demographic variables like locale, stream of education, year of the studies, type of educational institute, parents education.

·       A few number of studies based on the personal relations with their partners (break up in romance).

·       A number of studies determined that subclinical depression impacts on their quality of life negatively, social impairments and suicidal ideation also found with subclinical depression.



Depression may be a one among the foremost common causes of disability and common global ill health, altogether periods of life, among these periods college may be a period of change as adolescents develop new skills, experiences, expand social networks and gain knowledge It are often a stressful life event for several students getting to college or university as they agree to change in lifestyle, community and relationship changes. The transition from adolescence to young adulthood presents significant challenges like the chance to manage one’s life and affect more independent roles. A number of them adjust with these challenges and a few couldn’t manage these stressors which can cause the depression, so it's necessary to try and do further intervention programs to prevent the subclinical depression in college students.

Importance in education:

Depression is a taboo subject in our culture. Having a basic understanding of subclinical depression will assist students who frequently suffer from various levels of depression, as well as parents, teachers and healthcare providers, in expanding their knowledge. It will also help in the early detection of symptoms and will improve the mental health status of those who are suffering from it.

Future significance:

To minimize the number of occurrences of subclinical depression, also known as the primary stage of major depression, it is critical to recognize in youths so that it may be prevented at this time. It's also crucial to educate and teach family members about the significance of the symptoms so that they can be identified and treated earlier.


        Study based on only early adult or college student’s even subclinical depression is very common among elderly.



1.     Al-Windi (2005). A Depression in general practice. Nord Journal of Psychiatry, 59 (4), 272-277.

2.     Asante, K. O. & Andoh-Arthur, J. (2015). Prevalence and determinants of depressive symptoms among university students in Ghana. Journal of Affective Disorders, 171, 161–166.

3.     Backenstrass, M., Frank, A., Joest, K., Hingmann, S., Mundt, C. & Kronmüller, K. (2006). A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care. Journal of Comparative Psychiatry, 47, 35-41.

4.     Baumeister, H. & Morar, V. (2008). The impact of clinical significance criteria on subthreshold depression prevalence rates.  Acta Psychiatrica Scandinavica, 118, 443-450.

5.     Bayram, N. & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology, 43,667–672.

6.     Chen, L.,  Wang, L., Hui Qiu, X., Yang, X., Xue Qiao, Z., Yang Y., J. &  Liang, Y. (2013). Depression among Chinese University Students, Prevalence and Socio-Demographic Correlates. PLOS One. 8(3), e58379.

7.     Cuijpers, P., de Graaf, R. & Van Dorsselaer, S. (2004). Minor depression, risk profiles, functional disability, health care use and risk of developing major depression. Journal of Affective Disorder, 79, 71-79.

8.     Cuijpers, P. & Smit, F. (2004). Subthreshold depression as a risk indicator for major depressive disorder, a systematic review of prospective studies. Acta Psychiatrica Scandinavica, 109, 325-331.

9.     Cukrowicz, K. C., Schlegel, E. F., Smith, P. N., Jacobs, M. O., Orden, K. A. V., Paukert, A. L., Pettit, J. W. & Joiner, T. E. (2011). Suicide ideation among college students evidencing subclinical depression.  Journal of American college Health, 59, (7).575-581.

10.  Da Graaf, L. E., Huibers, M. J., Cuijpers, P. & Arntz, A. (2010). Minor and major depression in the general population, does dysfunctional thinking play a role. Comparative Psychiatry, 51 (3), 266-274.

11.  Deb, S., Parveen, R., B., Thomasa, S., Vishnu Vardhan, V., Rao, T., P. & Khawaja, N. (2016). Depression among. Indian university students and its association with perceived university academic environment, living arrangements and personal issues. Asian Journal of Psychiatry, 23, 108–117.

12.  Dubini, A., Mannheimer, R. & Pancheri, P. (2009). Depression in the community, results of the first Italian survey. International journal of Clinical Psychopharmacology, 16 (1), 49-53.

13.  Fergusson, D., M., Horwood, L., J., Ridder, E., M. & Beautrais, A., L. (2005). Subthreshold depression in adolescence and mental health outcomes in adulthood. Archive of General Psychiatry, 62, 66-72.

14.  Fils, J. M., Penick, E. C., Nickel, E. J., Othmer, E., DeSouza, C., Gabrielli,  W. F. & Hunter, E. E. (2010). Minor versus major depression, a comparative clinical study. Primary Care Companion Journal of Clinical Psychiatry, 12 (1).PCC. 08m00752.doi: 10.4088/PCC.08 m0075 2blu

15.  Gómez-Restrepo, C., Bohórquez, A., Pinto Masis, D., Gil Laverde, J. F., Rondon Sepulveda, M. & Paz Granados, N. (2004). The prevalence of and factors associated with depression in Colombia. Review of Panama Salud Publication, 16 (6), 378-386.

16.  Iqbal, S., Gupta, S. & Venkatarao, E. (2015). Stress, anxiety and depression among medical undergraduate students & their socio-demographic correlates. Indian Journal of Medical Research, 141, 354-357.

17.  Jha, K. K., Singh, S. K., Nirala, S. K., Kumar, C., Kumar, P. &  Agrawal, N. (2017). Prevalence of Depression among School-going Adolescents in an Urban Area of Bihar India. Indian Journal of Psychological medicine, 39(3), 287–292.

18.  Johnson, J. G., Cohen, P. & Kasen, S. (2009). Minor depression during adolescence and mental health outcomes during adulthood. British Journal of Psychiatry, 195, 264-265.

19.  Karmakar, T. & Behera, S. K. (2017). Depression among the College Students, an Empirical Study. International Journal of Education and Applied Social Science, 8, 163-170.

20.  Kaur, S., Deepti, S. S. & Lal, M. (2014). Prevalence and Correlates of Depression among College going Students of District Amritsar, India. International Research Journal of Medical Science, 2, 5-9.

21.  Kessler, C. R., Berglund, Demler, O. P., Jin, R., Merikangas, R. K. & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Co-morbidity Survey application. Archive of General Psychiatry, 62, 593- 603.

22.  Kumar, S. G., Kattimani, S., Sarkar, S. & Kar, S. S. (2018). Prevalence of depression and its relation to stress level among medical students in Puducherry, India. Industrial Psychiatry journal, 26, 86-90.

23.  Kumar, S. G., Jain, A. & Hegde, S. (2012). Prevalence of depression and its associated factors using Beck depression Inventory among students of medical college Karnataka. Indian Journal of Psychiatry, 54, 22-36.

24.  Margitics, F. (2006). Interrelation between predisposition factors and sub clinical depression syndrome at college students. Psychiatria Hungarica. 20, 211-223.

25.  Nahas, A. M., Elkalmi, R. M., Al-Shami, A. M. & Elsayed, T. M. (2019). Prevalence of depression among health sciences students, Findings from a public university in Malaysia. Journal of Pharmacy and Bioallied Science, 11, 170-5.

26.  Naushad, S., Farooqui, W., Sharma, S., Rani, M., Singh, R. & Verma, S. (2014). Study of proportion and determinants of depression among college students in Mangalore city. Nigerian Medical Journal, 55(2), 156–160.

27.  Nieremberg, A. A., Rapaport, M. H., Schettler, P. J., Howland, R. H., Smith, J. A., Edwards, D., Schneider, T. & Mischoulon, D. (2010). Deficits in Psychological Well-Being and Quality-of-Life in Minor Depression, Implications for DSM-V. CNS Neuroscience Therapeutics, 16, 208-216.

28.  Othieno, C. J., Okoth, R. O., Peltzer, K., Pengpid, S. & Malla, L. O. (2014). Depression among university students in Kenya: Prevalence and socio-demographic correlates. Journal of Affective Disorders, 165, 120-125.

29.  Padampriya, b. & Vijayalaxmi, D. (2014). Level of depression in college students. International Journal of Psychology and Psychiatry, 2, 184-192.

30.  Patil, A. S. (2015). Depression among adolescents, A cross sectional study. International Journal of Current Research Academy Review. 3,183–6.

31.  Raghunathan, D., Ramakrishnan, D., Iris Valsan, K. V. & Ambika, S. (2019). Prevalence of Depression among Students of a Dental Tertiary Care Center in Kerala. Indian Journal of Community Medicine, 44, S14-8.

32.  Regeer, E. J., Krabbendam, L., de Graaf, R., Have, M., Nolen, W. A. & Van Os, J. (2006). A prospective study of the transition rates of subthreshold (hypo) mania and depression in the general population. Psychological Medicine journal, 36, 619-627.

33.  Rucci, P., Gherardi, S., Tansella, M., Piccinelli, M., Berardi, D., Bisoffi, G., Corsino, M. A. & Pini, S. (2003). Subthreshold psychiatric disorders in primary care, prevalence and associated characteristics. Journal of Affective Disorder, 76, 171-181.

34.  Sabbarwal, B., Puranik, M. P. & Sowmya, K. R. (2019). Prevalence of depressive symptoms and associated factors among dental students, a cross-sectional study. Journal of Global Oral Health, 2(1), 16-22.

35.  Samson, S. L. & Hema Nalini, M. (2020). A study on depression among college students. Studies in Indian Place Names, 40 (12), 247-269.

36.  Sandal, R. K., Goel, N. K.,  Sharma, M. K., Kaur Bakshi  R.,  Singh, N. & Kumar, D. (2017). Prevalence of Depression, Anxiety and Stress among school going adolescent in Chandigarh. Journal of family medicine Prime Care, 6(2), 405-410.

37.  Schneider, G.,  Kruse, A., Nehen, H. G., Senf, W. & Heuft, G. (2000). The Prevalence and differential Diagnosis of Subclinical Depressive Syndromes in Inpatients 60 Years and Older. Journal of Psychotherapy and Psychosomatics, 69(5), 251-60.

38.  Singh, A., Lal, A. & shekhar. (2011). Prevalence of Depression among Medical Students of a Private Medical College in India. Journal of Health and Allied Sciences, 9, (4), 1-3.

39.  Singhal, M., Manjula, M. & John Vijay Sagar, K. (2016). Subclinical depression in urban Indian adolescents, Prevalence, felt needs, and correlates. Indian Journal of Psychiatry, 58, 394-402.

40.  Wilson, Bohnert, E. A., Ambrose, A., Davis, Y. D., Jones, M. D. & Magee, J. M. (2014). Social, behavioral, and sleep characteristics associated with depression symptoms among undergraduate students at a women’s college, across-sectional depression survey, 2012. BMC Women's Health, 14, (8), 2-9.


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