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Review
. 2014 Oct;205(4):268-74.
doi: 10.1192/bjp.bp.113.138784.

Psychotherapy for subclinical depression: meta-analysis

Pim Cuijpers  1 , Sander L Koole  1 , Annemiek van Dijke  1 , Miquel Roca  1 , Juan Li  1 , Charles F Reynolds 3rd  1
Affiliations
Review

Psychotherapy for subclinical depression: meta-analysis

Pim Cuijpers et al. Br J Psychiatry. 2014 Oct.

Abstract

Background: There is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.

Aims: To examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.

Method: We conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.

Results: The target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23-0.47; NNT = 5, 95% CI 4-8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.

Conclusions: Psychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.

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Conflict of interest statement

Declaration of interest

None.

Figures

Fig. 1
Fig. 1
Flowchart of inclusion of studies (MDD, major depressive disorder)
Fig. 2
Fig. 2
Standardised effect sizes of psychotherapy for subclinical depression compared with control conditions: Hedges’ g.
Fig. 3
Fig. 3
Effects of psychological treatments on incidence of major depression: risk ratios (RR) at 6-month and 12-month follow-up.
See this image and copyright information in PMC

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References

    1. Cuijpers P, De Graaf R, Van Dorsselaer S. Minor depression: risk profiles, functional disability, health care use and risk of developing major depression. J Affect Disord 2004; 79: 71–9 - PubMed
    1. Horwarth E, Johnson J, Klerman GL, Weissman MM. Depressive symptoms as relative and attributable risk factors for first-onset major depression. Arch Gen Psychiatry 1992; 49: 817–23 - PubMed
    1. Rucci P, Gherardi S, Tansella M, Piccinelli M, Berardi D, Bisoffi G, et al. Subthreshold psychiatric disorders in primary care: prevalence and associated characteristics. J Affect Disord 2003; 76: 171–81 - PubMed
    1. Chachamovich E, Fleck M, Laidlaw K, Power M. Impact of major depression and subsyndromal symptoms on quality of life and attitudes toward aging in an international sample of older adults. Gerontologist 2008; 48: 593–602 - PubMed
    1. Goldney RD, Fisher LJ, Dal Grande E, Taylor AW. Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population. Soc Psychiatry Psychiatr Epidemiol 2004; 39: 293–8 - PubMed