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Psychotherapy for subclinical depression: meta-analysis

  • Pim Cuijpers (a1), Sander L. Koole (a2), Annemiek van Dijke (a3), Miquel Roca (a4), Juan Li (a5) and Charles F. Reynolds (a6)...
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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Copyright
Corresponding author
Professor Pim Cuijpers, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Email: p.cuijpers@vu.nl.
Footnotes
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C.F.R. is supported by National Institute of Mental Health grant P30 MH90333; no other financial support was received for this study.

Declaration of interest

None.

Footnotes
References
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Psychotherapy for subclinical depression: meta-analysis

  • Pim Cuijpers (a1), Sander L. Koole (a2), Annemiek van Dijke (a3), Miquel Roca (a4), Juan Li (a5) and Charles F. Reynolds (a6)...
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