Cited by 375Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Estimating remission from untreated major depression: a systematic review and meta-analysis

Whiteford, H. A., Harris, M. G., McKeon, G., Baxter, A., Pennell, C., Barendregt, J. J., Wang, J.·2013·Psychological Medicine

DOI 10.1017/s0033291712001717

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Abstract

Background: Few studies have examined spontaneous remission from major depression. This study investigated the proportion of prevalent cases of untreated major depression that will remit without treatment in a year, and whether remission rates vary by disorder severity. Method: Wait-list controlled trials and observational cohort studies published up to 2010 with data describing remission from untreated depression at ⩽2-year follow-up were identified. Remission was defined as rescinded diagnoses or below threshold scores on standardized symptom measures. Nineteen studies were included in a regression model predicting the probability of 12-month remission from untreated depression, using logit transformed remission proportion as the dependent variable. Covariates included age, gender, study type and diagnostic measure. Results: Wait-listed compared to primary-care samples, studies with longer follow-up duration and older adult compared to adult samples were associated with lower probability of remission. Child and adolescent samples were associated with higher probability of remission. Based on adult samples recruited from primary-care settings, the model estimated that 23% of prevalent cases of untreated depression will remit within 3 months, 32% within 6 months and 53% within 12 months. Conclusions: It is undesirable to expect 100% treatment coverage for depression, given many will remit before access to services is feasible. Data were drawn from consenting wait-list and primary-care samples, which potentially over-represented mild-to-moderate cases of depression. Considering reported rates of spontaneous remission, a short untreated period seems defensible for this subpopulation, where judged appropriate by the clinician. Conclusions may not apply to individuals with more severe depression.

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“(23) reported that close to half of prevalent cases of untreated major depression will not remit spontaneously in a given year; these rates are even lower (by ~20%–30%) among those with more severe depression.”
Background
Protocol for a randomized control trial of the Building Regulation in Dual Generations Program (BRIDGE): preventing the intergenerational transmission of mental illness in at-risk preschool children
Penner‐Goeke, L., Belows, M., Kristjanson, A., Andrade, B. F., Cameron, E. E., Giuliano, R. J., Katz, L. Y., Kelly, L. E., Letourneau, N. L., Mota, N. P., et al. (2023) · Trials · doi:10.1186/s13063-023-07591-8 · Cited by 2
“Participants will also be instructed to complete weekly Diary Cards to track DBT skills use each week [40].”
Background
Early-life risk factors for depression among young adults in the United States general population: Attributable risks and gender differences
Bruffaerts, R., Caywood, K., & Axinn, W. G. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.07.090 · Cited by 3
Telemedizin bei psychischen Erkrankungen: Vorstellung und erste Ergebnisse eines telefonbasierten Betreuungsansatzes
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Cost-utility analysis of school-based depression prevention interventions for Thai adolescents with subsyndromal depression
Rungmueanporn, L. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06984-0 · Cited by 2
“Owing to the limitations of the available evidence, the SubDepres-sion -to- Healthy transition used the remission probability of untreated depression in the adult population [42].”
Patient viewpoint: The case for exploring non-seizure alternatives to ECT
Dubey, C. J. (2025) · International Journal of Risk & Safety in Medicine · doi:10.1177/09246479251377340 · Cited by 2
Model biomedyczny w psychopatologii. Krytyczny szkic historyczny, współczesny kontekst i problemy etyczne
Stupak, R. (2020) · Diametros · doi:10.33392/diam.1260 · Cited by 5
Stepped Care for Depression: A Systematic Review and Feasibility Study
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Epidemiological evidence linking stress and depression with CVD
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Integration of Measurement-Based Care for Youth Depression and Suicidality Using VitalSign6
Mitchell, T. B., Wakefield, S. M., Rezaeizadeh, A., Minhajuddin, A., Pipes, R., Mayes, T. L., Elmore, J. S., & Trivedi, M. H. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01680-8 · Cited by 2
“It was expected that regular follow-up assessments would be conducted in these clinics and that remission rates would be around 20% (Whiteford et al. 2013).”
The Impact of COVID-19 on Older Black and Hispanic Workers’ Perceptions of their Workplace
Jason, K., Sargent, A. C., & Payne, J. (2024) · Occupational Health Science · doi:10.1007/s41542-024-00179-x · Cited by 2
“…depression in later life is often comorbid with physical issues (Blazer, 2003; Christ et al., 2007), contributing to morbidity, limited functioning (Whiteford et al., 2013), decreased work performance (Wang, 2005), increased work impairment, disability, and absence (Greenberg et al., 2015; Stewart…”
Investigating the Added Value of Beck’s Depression Inventory in Atherosclerosis Prediction: Lessons from Paracelsus 10,000
Dienhart, C., Aigner, E. S., Iglseder, B., Frey, V., Gostner, I., Langthaler, P. B., Paulweber, B., Trinka, E., & Wernly, B. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154492 · Cited by 2
“Given that depression has a variable persistence of around 18%, as well as remission rates varying between 12–60% [64], using actual DSM criteria (which we do not have available) might have substantially altered our results.”
Background
The epidemiology, burden, and treatment of mental disorders in primary care
Puschner, B., Kösters, M., Bouché, L., & Weinmann, S. (2017) · Oxford University Press eBooks · doi:10.1093/med/9780198746638.003.0001 · Cited by 2
Predictors and correlates of outcome for dorsolateral, dorsomedial, and orbitofrontal rTMS in major depressionPreprint
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A Randomized Controlled Trial of a Therapist- Assisted Internet Cognitive Behaviour Therapy Program for Women with Postpartum Depression
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Characteristics of hospitalized patients with depression and their relationship with the surrounding environment: A study in a class 3A hospital in Shanghai
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El cliente: el verdadero agente del cambio en psicoterapia
Gismero-González, E. (2021) · Miscelánea Comillas. Revista de Ciencias Humanas y Sociales · doi:10.14422/mis.v79.i154.y2021.011 · Cited by 2
“Por ejemplo, un meta-análisis sobre recuperación espontánea en depresión aporta datos reveladores: Whiteford et al. (2013) revisan los 21 estudios que analizan la evolución de listas de espera de personas diagnosticadas de depresión mayor para establecer el índice de recuperación espontánea.”
Background
Tele-Health Psychological Interventions in Breast Cancer at the Time of Coronavirus: A Narrative Review
Bertolucci, I. (2023) · Journal of Psychology and Psychotherapy Research · doi:10.12974/2313-1047.2023.10.07 · Cited by 1
Bielefelder Fragebogen zur Lebenszufriedenheit (BIFL)
Zotschew, T., Kley, H., Möllmann, A., Schlechter, F., & Heinrichs, N. (2024) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000745 · Cited by 1
Prognosis of unipolar depression
Boberg, M., & Videbech, P. (2024) · Ugeskrift for Læger · doi:10.61409/v02240120 · Cited by 1
Psychiatric outcomes and long-term school and work-related disability in offspring of parents with depression and treatment-resistant depression
Brenner, P., Taipale, H. T., Josefsson, P., DiBernardo, A., Tanskanen, A. J., Mittendorfer‐Rutz, E., & Reutfors, J. (2025) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-02988-z · Cited by 1
“…one-year timeframe in the present study are spontaneous remission of depression, which occurs in 24% of patients around 12 months into the episode [42], and, conversely, the recurrence of depression after initial remission, affecting 25% of patients within 1–3 years after remission and 40–60% of…”
Clinical characteristics of natural recovery in trichotillomania and skin picking disorder
Neelapu, M., & Grant, J. E. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1681068 · Cited by 1
“Prior research has shown that many of those with alcohol use disorder, gambling disorder, depression, and obsessive-compulsive disorder (OCD) naturally recover (1 – 6).”
Virtual reality therapy for adolescent depression: a prospective observational study
Gao, H., Li, R., Wu, S., Huang, W., Qian, L., Zhang, M., & Li, K. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07729-9 · Cited by 1
“This rate is comparable to those of standard therapies assessed over longer periods in clinical trials [26, 27].”
The association of employee and workplace characteristics with work disability trajectories before, during and after psychotherapy in occupational health services – a Finnish register-based longitudinal study
Selinheimo, S., Kurkela, O., Järnefelt, H., Vuokko, A., Heinonen, E., & Väänänen, A. (2026) · BMC Health Services Research · doi:10.1186/s12913-025-13943-8 · Cited by 1
“Firstly, earlier data show that approximately every fifth patient diagnosed with depression or exceeding clinical thresholds on standardized symptom severity questionnaires will spontaneously recover within three months, and half within 12 months [41, 42].”
Identifying neurophenotypes of major depressive disorder through normative model of regional homogeneity
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“Thus, our ﬁ ndings position the two neurophenotypes at distinct loci along a cortical processing hierarchy, offering a parsimonious model for understanding heterogeneous pathophysiology in MDD as dysregulation of this fundamental functional axis.”
Adolescent Mental Health Care and Stigma
Maulik, P. K., Yatirajula, S. K., Kallakuri, S., Paslawar, S., Ghosh, A., Rastogi, A., Mukherjee, A., Khan, R., Sagar, R., Lempp, H. K., et al. (2026) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2026.0603 · Cited by 1
Expanding the Options Through Nine Steps
Cornish, P. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-48055-4_4 · Cited by 1
“Research suggests this, alone, can be an effective intervention with at least 20% of help-seekers recovering after making an initial contact and receiving no specific treatment (Whiteford et al., 2012).”
Background
Let's talk about the negative experiences of Black mental health service users in England: Now is the moment to consider watchful waiting to support their recovery
Tuffour, I. (2021) · Nursing Inquiry · doi:10.1111/nin.12484 · Cited by 1
Perspectives on the course of major depression: Trajectories of remission and relapse with CBT or no treatment
Chauvin, G. V., Hoyt, D. L., & Otto, M. W. (2022) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2022.04.003 · Cited by 1
Evaluation of the Implementation of the FLOW Program for Increasing Access to Mental Health Care
Hundt, N. E., Plasencia, M., Amspoker, A. B., Yusuf, Z. I., Walder, A. M., Nagamoto, H. T., Kim, B., Tsao, C. G.-J., & Smith, T. L. (2024) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-024-09886-3 · Cited by 1
Mental disorder symptoms and diagnoses are differently associated with labour market attachment and registered income until midlife: The Northern Finland Birth Cohort 1966
Majuri, T., Huikari, S., Jääskeläinen, E., Ala‐Mursula, L., Rissanen, I. L., & Korhonen, M. (2024) · International Journal of Social Psychiatry · doi:10.1177/00207640241299384 · Cited by 1
“Conversely, individuals with a mental disorder diagnosis may be in remission (Catalan et al., 2021; Whiteford et al., 2013), recovered (Catalan et al., 2021; Roach et al., 2023), misdiagnosed (Ayano et al., 2021) or overdiagnosed (Davis et al., 2016; Thombs et al., 2019) and currently without…”
Natural remission rates of depression among rural adult populations in India: multilevel analysis of the SMART Mental Health Project
Maulik, P. K., Daniel, M., Ghosh, A., Devarapalli, S., Kallakuri, S., Kaur, A., Sagar, R., Billot, L., Thornicroft, G., Saxena, S., et al. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2025.68 · Cited by 1
“Lower remission among those with more severe depression, in this study, has also been reported earlier.”
Self-reported attitudes and strategies of physicians towards medication reduction and discontinuation
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“It has been suggested that 50–65% of patients with major depression (Roach et al., 2023; Whiteford et al., 2013) and one-third of patients with psychotic symptoms may recover spontaneously (Gotfredsen et al., 2017), mostly within a year.”
Tacting of Function in College Student Mental Health: An Online and App-Based Approach to Psychological Flexibility
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Major Depression: A Cognitive-Behavioral Perspective to Pathology, Case Conceptualization, and Treatment
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Authors: Whiteford, H. A., Harris, M. G., McKeon, G., Baxter, A., Pennell, C., Barendregt, J. J., & Wang, J.
Affiliations: The University of Queensland (AU)
Queensland Centre for Mental Health Research (AU)
University of Calgary (CA)
Corresponding author: Whiteford, H. A.
ORCID: Whiteford, H. A.
Harris, M. G.
McKeon, G.
Baxter, A.
Wang, J.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2012-08-10
Volume: 43
Issue: 8
Pages: 1569-1585
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291712001717
OpenAlex: W2039156670
Cited by: 375
References: 72
Citations by year: 2026: 19 · 2025: 26 · 2024: 57 · 2023: 43 · 2022: 32 · 2021: 39 · 2020: 33 · 2019: 32 · 2018: 24 · 2017: 21 · 2016: 18 · 2015: 17 · 2014: 9 · 2013: 2 · 2012: 2
FWCI: 1.36
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: University of Queensland
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: major depressive disorder, spontaneous regression, untreated depression, remission rate, disorder severity, primary care, child and adolescent depression, treatment coverage
MeSH terms: Adolescent, Adult, Child, Major Depressive Disorder, Humans, Remission, Spontaneous

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Estimating remission from untreated major depression: a systematic review and meta-analysis

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