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 Remission was defined as rescinded diagnoses or below threshold scores on standardized symptom measures.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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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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