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. 2023 Jun;53(8):3611-3620.
doi: 10.1017/S0033291722000241. Epub 2022 Feb 14.

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population

Ruibin Zhang  1   2 , Xiaoling Peng  3 , Xiaoqi Song  1 , Jixin Long  1 , Chanyu Wang  1 , Chichen Zhang  4 , Ruiwang Huang  5 , Tatia M C Lee  6   7   8
Affiliations

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population

Ruibin Zhang et al. Psychol Med. 2023 Jun.

Erratum in

Abstract

Background: Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established.

Methods: By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals).

Results: No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96).

Conclusions: Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.

Keywords: Depression; meta-analysis; mood; prevalence; spectrum disorder.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Flowchart of study selection and identification following the PRISMA statement. PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses. MD, major depression; StD, subthreshold depression.
Fig. 2.
Fig. 2.
Meta-analysis of the prevalence of subthreshold depression under different subgroup analyses. StD, subthreshold depression; MD, major depression. CI, confidence interval.
Fig. 3.
Fig. 3.
Meta-analysis of the prevalence of subthreshold depression under subgroup analysis using different diagnostic criteria.
Fig. 4.
Fig. 4.
Meta-analysis of the prevalence of subthreshold depression under subgroup analysis using the Newcastle-Ottawa scale.
Fig. 5.
Fig. 5.
Meta-analysis of the IRR of subthreshold depression developing into major depression under different subgroup analyses. StD, subthreshold depression; MD, major depression; IRR, incidence risk ratio.
See this image and copyright information in PMC

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