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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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