| Title: |
Psychological intervention in individuals with subthreshold depression : individual participant data meta-analysis of treatment effects and moderators |
| Authors: |
Harrer, Mathias; Sprenger, Antonia A.; Illing, Susan; Adriaanse, Marcel C.; Albert, Steven M.; Allart, Esther; Almeida, Osvaldo P.; Basanovic, Julian; van Bastelaar, Kim M. P.; Batterham, Philip J.; Baumeister, Harald; Berger, Thomas; Blanco, Vanessa; Bø, Ragnhild; Casten, Robin J.; Chan, Dicken; Christensen, Helen; Ciharova, Marketa; Cook, Lorna; Cornell, John; Davis, Elysia P.; Dobson, Keith S.; Dozeman, Elsien; Gilbody, Simon; Hankin, Benjamin L.; Haringsma, Rimke; Hoorelbeke, Kristof; Irwin, Michael R.; Jansen, Femke; Jonassen, Rune; Karyotaki, Eirini; Kawakami, Norito; Klein, J. Philipp; Konnert, Candace; Imamura, Kotaro; Landrø, Nils Inge; Lara, María Asunción; Le, Huynh-Nhu; Lehr, Dirk; Luciano, Juan V.; Moritz, Steffen; Mossey, Jana M.; Muñoz, Ricardo F.; Muntingh, Anna; Nobis, Stephanie; Olmstead, Richard; Otero, Patricia; Pibernik-Okanović, Mirjana; Pot, Anne Margriet; Reynolds, Charles F.; Rovner, Barry W.; Sanabria-Mazo, Juan P.; Sander, Lasse B.; Smit, Filip; Snoek, Frank J.; Spek, Viola; Spinhoven, Philip; Stelmach, Liza; Terhorst, Yannik; Vázquez, Fernando L.; Leeuw, Irma Verdonck-de; Watkins, Ed; Yang, Wenhui; Wong, Samuel Yeung Shan; Zimmermann, Johannes; Sakata, Masatsugu; Furukawa, Toshi A.; Leucht, Stefan; Cuijpers, Pim; Buntrock, Claudia; Ebert, David Daniel |
| Source: |
BRITISH JOURNAL OF PSYCHIATRY ; ISSN: 0007-1250 ; ISSN: 1472-1465 |
| Publication Year: |
2025 |
| Collection: |
Ghent University Academic Bibliography |
| Subject Terms: |
Social Sciences; Meta-analysis; depressive disorders; prevention; psychological treatments; precision medicine |
| Description: |
Background It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission. Aims To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers. Method Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment-covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values. Results IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = -0.48 to -0.27). Effects could not be ascertained up to 24 months (s.m.d. = -0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27-2.79), reliable improvement (relative risk = 1.38-3.17), deterioration (relative risk = 0.67-0.54) and close-to-symptom-free status (relative risk = 1.41-2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = -0.33 for PHQ-9 = 5). Conclusions Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores >= 10. For very mild symptoms, scalable treatments could be an attractive option. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://biblio.ugent.be/publication/01K1JNS1CDHD6CG23PKETMT8X5; https://doi.org/10.1192/bjp.2025.56; https://biblio.ugent.be/publication/01K1JNS1CDHD6CG23PKETMT8X5/file/01K1JWN9FPD32TXTY1G97QEVYB |
| DOI: |
10.1192/bjp.2025.56 |
| Availability: |
https://biblio.ugent.be/publication/01K1JNS1CDHD6CG23PKETMT8X5; https://hdl.handle.net/1854/LU-01K1JNS1CDHD6CG23PKETMT8X5; https://doi.org/10.1192/bjp.2025.56; https://biblio.ugent.be/publication/01K1JNS1CDHD6CG23PKETMT8X5/file/01K1JWN9FPD32TXTY1G97QEVYB |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.68F7EE3A |
| Database: |
BASE |