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Psychotherapy for subclinical depression: meta-analysis
Open accessAbstract
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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“there is evidence that psychological treatments are beneficial even for subthreshold depressive symptoms.18”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [18]
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“Psychological interventions for the prevention of MDD have been shown to effectively reduce depression symptoms (Cuijpers et al., 2014) and avoid or at least delay MDD onset (Cuijpers et al., 2021; van Zoonen et al., 2014) in people with known risk factors (selective prevention) or with subthreshold symptoms (indicated prevention).”
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“A recent meta-analysis shows that psychological treatment combined with antidepressants is more effective than antidepressants alone.159”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [159]
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“Accumulated evidence shows that combined psychological and antidepressant treatment is more effective than psychological treatment alone or psychological treatment with placebo.159,160”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [159]
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“Early meta-analyses not focusing on young individuals showed that indicated psychological interventions, generally based on cognitive behavioural therapy, can reduce the incidence of depression 114,117”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [117]
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“Psychological interventions for the prevention of MDD have been shown to effectively reduce depression symptoms (Cuijpers et al., 2014) and avoid or at least delay MDD onset (Cuijpers et al., 2021; van Zoonen et al., 2014) in people with known risk factors (selective prevention) or with…”
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Metadata
- Authors
- Cuijpers, P., Koole, S. L., van Dijke, A., Roca, M., Li, J., & Reynolds, C. F.
- Affiliations
- Chinese Academy of Sciences (CN)
- University of Pittsburgh (US)
- Corresponding author
- Cuijpers, Pim
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2014-10
- Volume
- 205
- Issue
- 4
- Pages
- 268-274
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC4180844
- OpenAlex
- W2104231578
- Semantic Scholar
- 4c6c354e904fb4624d5893812307a4e05c6f5d81
- Cited by
- 193
- References
- 42
- Citations by year
- 2026: 20 · 2025: 20 · 2024: 19 · 2023: 13 · 2022: 15 · 2021: 14 · 2020: 15 · 2019: 11 · 2018: 24 · 2017: 19 · 2016: 11 · 2015: 10 · 2014: 1
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion)
- Multilingual Matters (Channel View Publications) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000005)
- National Institute of Mental Health (P30MH090333, P30 MH90333, MH90333)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- subthreshold depression, psychotherapy, depressive symptoms, major depressive disorder, non-specific treatment effects, treatment effectiveness
- MeSH terms
- Major Depressive Disorder, Depressive Disorder, Humans, Psychotherapy, Treatment Outcome
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