Pim Cuijpers1, Sander L Koole1, Annemiek van Dijke1, Miquel Roca1, Juan Li1, Charles F Reynolds1. 1. Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands, and Leuphana University, Lünebrug, Germany; Sander L. Koole, PhD, Department of Clinical Psychology, VU University Amsterdam, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre Amsterdam, The Netherlands; Annemiek van Dijke, PhD, Delta Psychiatrisch Centrum, Poortugaal, The Netherlands; Miquel Roca, MD, PhD, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS). Hospital Juan March, Rediapp, University of Balearic Islands, Palma de Mallorca, Spain; Juan Li, PhD, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Charles F. Reynolds III, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
Abstract
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. Royal College of Psychiatrists.
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. Royal College of Psychiatrists.
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