The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population
Open accessAbstract
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.
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Mild to moderate depression is a precursor to and risk factor for major depression.
“mild to moderate depression has been established as a precursor to and risk factor for major depression [6].”
From Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial (2023) · cites this paper as [6]
The Results section reports that people with subthreshold depression were more likely to develop major depression, and the Abstract Conclusions call it a significant precursor and risk factor. But the paper studies subthreshold or minor depression, not the broader category of “mild to moderate depression”; it also phrases the precursor conclusion as a possibility rather than something definitively established. Page numbers were not provided in our copy. (LLM, conf=0.87)
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“In addition, mild to moderate depression has been established as a precursor to and risk factor for major depression [6].”
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“For example, individuals with subclinical anxiety and depression are at increased risk for developing clinical disorders by 2.5 and 3 times, respectively [3,4].”
Influential
- Authors
- Zhang, R., Peng, X., Song, X., Long, J., Wang, C., Zhang, C., Huang, R., & Lee, T. M. C.
- Affiliations
- Zhujiang Hospital (CN)
- Southern Medical University (CN)
- South China Normal University (CN)
- University of Hong Kong (HK)
- Corresponding author
- Lee, Tatia M. C.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022-02-14
- Volume
- 53
- Issue
- 8
- Pages
- 3611-3620
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC10277767
- OpenAlex
- W4213362252
- Cited by
- 174
- References
- 68
- Citations by year
- 2026: 53 · 2025: 72 · 2024: 35 · 2023: 11 · 2022: 3
- FWCI
- 28.59
- Type
- journal article
- Language
- en
- Update notices
- correction (2022-02-14)
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- subthreshold depression, major depressive disorder, depression prevalence, depression incidence, minor depression, risk factors for depression, adolescent depression, geriatric depression
- MeSH terms
- Adolescent, Adult, Aged, Depression, Depressive Disorder, Major, Major Depressive Disorder, Humans, Risk Factors, Prevalence, Odds Ratio
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