title: Psychotherapy for subclinical depression: meta-analysis.
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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: 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.
authors.forename: Sander L
authors.initials: SL
authors.lastname: Koole
authors.affiliation: 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.
authors.forename: Annemiek
authors.initials: A
authors.lastname: van Dijke
authors.affiliation: 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.
authors.forename: Miquel
authors.initials: M
authors.lastname: Roca
authors.affiliation: 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.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: 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.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D003866:Depressive Disorder / Q000628:therapy*; D003865:Major Depressive Disorder / Q000517:prevention & control; D006801:Humans; D011613:Psychotherapy; D016896:Treatment Outcome