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• Adolescents with depression were marginally faster than those in the comparison group to recognise sadness, although this trend disappeared once covarying for age and use of antidepressant medication. • Within the depression group, severity of depression symptoms and borderline personality features were associated with poorer emotional facial expression recognition (EFER) performance. • Discrepancies between group and within-group differences may explain some of the clinical heterogeneity observed in studies of EFER amongst adolescents with depression. • Studying clinical features in relation to EFER in adolescents with depression allows for a more nuanced understanding of social difficulties that may be experienced in depression. Studies have reported that emotional facial expression recognition (EFER) may be altered in individuals with depression. This study examined EFER in adolescent girls with and without depression and further examined associations between relevant clinical features of depression and EFER. Fifty adolescent girls aged 12 to 19 years old meeting criteria for depression or subthreshold levels of symptomatology and 55 adolescent girls with no psychiatric diagnosis completed EFER tasks. Reaction time and accuracy for recognising expressions at high and low intensities, and sensitivity in recognising happiness, sadness, anger and fear were assessed. Data were analysed using linear mixed models. Adolescents with depression were marginally faster than those in the comparison group to recognize sadness, although this trend disappeared once covarying for age and antidepressant use. Amongst adolescents with depression, clinical features were associated with poorer EFER performance. In contrast, anxiety symptoms were linked to better accuracy and heightened sensitivity towards happiness. A better understanding of EFER in adolescent girls with and without depression, and how clinical features might be associated with altered patterns of EFER could help to explain clinical heterogeneity observed in such studies of adolescents with depression. Knowledge of socio-cognitive alterations associated with depression will help to better develop and tailor interventions. [ABSTRACT FROM AUTHOR]

Background: Subthreshold depression is highly prevalent in adolescence, but compared to major depressive disorder, the clinical impact is under-researched. The aim of this review was to compare subthreshold depression and major depressive disorder in adolescents by reviewing available literature on epidemiology, risk factors, illness trajectories, brain anatomy and function, genetics, and treatment response.Methods: We conducted a scoping review of papers on subthreshold depression and major depressive disorder in adolescence published in English. Studies in adults were included when research in adolescence was not available.Results: We found that individuals with subthreshold depression were similar to individuals with major depressive disorder in several regards, including female/male ratio, onset, functional impairment, comorbidity, health care utilization, suicidal ideation, genetic predisposition, brain alterations, and treatment response. Further, subthreshold depression was about two times more common than major depressive disorder.Limitations: The definition of subthreshold depression is highly variable across studies. Adolescent-specific data are limited in the areas of neurobiology and treatment.Conclusions: The findings of the current review support the idea that subthreshold depression is of clinical importance and provide evidence for a spectrum, versus categorical model, for depressive symptomatology. Given the frequency of subthreshold depression escalating to major depressive disorder, a greater recognition and awareness of the significance of subthreshold depression in research, clinical practice and policy-making may facilitate the development and application of early prevention and intervention. [ABSTRACT FROM AUTHOR]