The DOI matches its Crossref record; 74 of the 74 references it cites were found in a registry or an index.
Untreated short-term course of major depression: a meta-analysis of outcomes from studies using wait-list control groups
Abstract
Introduction While the short-term response rates to antidepressant medication and placebo are well established, very little is known about the short-term course of untreated depression. Knowledge of the course of untreated depression can serve as a benchmark for assessing the true benefits of active treatment.Method A meta-analysis was performed analyzing the outcomes of all psychotherapy studies that randomized adult outpatients with major depressive disorder to a wait-list control group.Results Nineteen studies involving 221 subjects were reviewed. The mean decrease in Hamilton Rating Scale for Depression scores over 2-20 weeks was 11.9%, while the mean decrease in Beck Depression Inventory scores was 15.7%. Using a subsample of studies that reported individual outcomes, we estimated that 15 of 76 subjects (19.7%) improved to a degree comparable to what would be considered a positive response in antidepressant trials.Conclusions In the short-term, depressive symptomatology can be expected to decrease by about 10-15% on average without treatment. As many as 20% of subjects who participate in a short-term antidepressant trial may experience a spontaneous remission.
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In the citing paper
“A meta-analysis showed that untreated depressive symptoms could decrease by 10%–15%, on average.73”
From Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial (2020) · cites this paper as [73]
In the citing paper
“previous research has revealed spontaneous psychological symptom remission in wait-list participants in controlled trials (e.g., Posternak and Miller 2001).”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Posternak and Miller 2001
In the citing paper
“For STPP of depression remission rates between 45% and 70% at post-therapy assessment were published [26], while remission rates in primary-care settings (comparable to TAU) ranged between 20% and about 50% (6 months) [27-29].”
From Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: Study protocol for a randomized controlled trial (2012) · cites this paper as [28]
In the citing paper
“Because such methodology was not employed, it is difficult to know whether the changes were due to depressive symptoms resolving over time [21].”
From Web-based Cognitive Behavior Therapy: Analysis of Site Usage and Changes in Depression and Anxiety Scores (2002) · cites this paper as [21]
Citations
Cites
Handbook of Psychotherapy and Behavior Change
Garfield, S. L., Bergin, A. E., & Dryden, W. (1987) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.1.4.264a · Cited by 3,998
Davis, H. S. (1966) · JAMA · doi:10.1001/jama.1966.03100200106038 · Cited by 1,719
Manic-Depressive Insanity and Paranoia.
(1921) · JAMA · doi:10.1001/jama.1921.02630330070026 · Cited by 1,612
Manic Depressive Insanity and Paranoia
Kraepelin, E. (1921) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-192104000-00057 · Cited by 1,319
Handbook of Psychotherapy and Behavior Change
Kepecs, J. G. (1980) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1980.34.1.131 · Cited by 965
A meta-analysis of the efficacy of cognitive therapy for depression.
Dobson, K. S. (1989) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.57.3.414 · Cited by 823
Robinson, L. A., Berman, J., & Neimeyer, R. (1990) · Psychological bulletin · doi:10.1037/0033-2909.108.1.30 · Cited by 691
Cognitive-behavioral treatment for depressed adolescents
Lewinsohn, P. M., Clarke, G. N., Hops, H., & Andrews, J. (1990) · Behavior Therapy · doi:10.1016/s0005-7894(05)80353-3 · Cited by 612
Placebo Theory, Research , and Mechanisms
WHITE, L. E., Tursky, B., & SCHWARTZ, G. E. R. (1985) · Guilford Press eBooks · Cited by 485
Comparative effectiveness of psychotherapies for depressed elders.
Thompson, L. W., Gallagher-Thompson, D. E., & Breckenridge, J. S. (1987) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.55.3.385 · Cited by 465
Cited by
Sorted by citations
Comorbidity: a network perspective
Cramer, A. O. J., Waldorp, L. J., van der Maas, H. L. J., & Borsboom, D. (2010) · Behavioral and Brain Sciences · doi:10.1017/s0140525x09991567 · Cited by 1,575
“…is a well-established fact that depressive symptoms come (i.e., the system moves towards a “depressed” attractor state), and go (i.e., the system moves towards a “not depressed” attractor state), either through therapeutic intervention or spontaneous remission (e.g., see Posternak & Miller 2001).”
BackgroundLOWE, B. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00237-9 · Cited by 1,060
“…associated with high levels of personal suffering, increased disability days, and elevated risk of cardiovascular mortality and suicide (Wells et al., 1989; Broadhead et al., 1990; Ormel et al., 1994; Simon et al., 1995; Frasure-Smith et al., 2000; Penninx et al., 2001; Posternak and Miller, 2001).”
BackgroundAnderson, I. M., Ferrier, I. N., Baldwin, R., Cowen, P. J., Howard, L. M., Lewis, G., Matthews, K., McAllister-Williams, H., Peveler, R. C., Scott, J. L., et al. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088441 · Cited by 909
“A meta-analysis of waiting list controls in 19 studies of major depression found rating scale score decreases of 12–16% over 2–20 weeks and up to 20% of patients showed 50% or greater improvement (Posternak and Miller, 2001).”
Cleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759
“A meta-analysis of waiting list controls in 19 studies of major depression found rating scale score decreases of 12–16% over 2–20 weeks and up to 20% of patients showed 50% or greater improvement (Posternak and Miller, 2001), which compares with 30–32% response rate on placebo (Melander et al.”
ResultImproving access to psychological therapy: initial evaluation of two UK demonstration sites
Clark, D. M., Layard, R., Smithies, R., Richards, D. A., Suckling, R., & Wright, B. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.07.010 · Cited by 599
“20 comparisons, Posternak and Miller’s (2001) meta-analysis of wait-list control groups reports an average recovery rate from depression of approximately 20%, and a percentage change on the Beck Depression Inventory of approximately 16%.”
Background
Metadata
- Authors
- Posternak, M. A., & Miller, I.
- Affiliations
- Brown University (US)
- Corresponding author
- Posternak, Michael A.
- ORCID
- Miller, Ivan
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2001-10
- Volume
- 66
- Issue
- 2-3
- Pages
- 139-146
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2006252753
- Cited by
- 215
- References
- 65
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 19 · 2022: 5 · 2021: 11 · 2020: 7 · 2019: 9 · 2018: 11 · 2017: 10 · 2016: 15 · 2015: 10 · 2014: 10 · 2013: 10 · 2012: 19
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- untreated depression, major depressive disorder, spontaneous regression, waitlist control, outpatients, placebo response
- MeSH terms
- Adult, Major Depressive Disorder, Follow-Up Studies, Humans, Psychotherapy, Brief, Waiting Lists, Randomized Controlled Trials as Topic, Treatment Outcome, Benchmarking
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