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The risk of developing major depression among individuals with subthreshold depression: a systematic review and meta-analysis of longitudinal cohort studies

Published online by Cambridge University Press:  13 March 2018

Y. Y. Lee Open the ORCID record for Y. Y. Lee [Opens in a new window] ,
E. A. Stockings Open the ORCID record for E. A. Stockings [Opens in a new window] ,
M. G. Harris ,
S. A. R. Doi Open the ORCID record for S. A. R. Doi [Opens in a new window] ,
I. S. Page ,
S. K. Davidson Open the ORCID record for S. K. Davidson [Opens in a new window]  and
J. J. Barendregt
Y. Y. Lee*
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland, Australia Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, Queensland, Australia
E. A. Stockings
Affiliation:
National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, New South Wales, Australia
M. G. Harris
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland, Australia Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, Queensland, Australia
S. A. R. Doi
Affiliation:
Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
I. S. Page
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland, Australia Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, Queensland, Australia
S. K. Davidson
Affiliation:
Department of General Practice, Melbourne Medical School, University of Melbourne, Carlton, Victoria, Australia
J. J. Barendregt
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland, Australia Epigear International Pty Ltd, Sunrise Beach, Queensland, Australia
*
Author for correspondence: Y. Y. Lee, E-mail: y.lee5@uq.edu.au
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Abstract

Background

Studies have consistently shown that subthreshold depression is associated with an increased risk of developing major depression. However, no study has yet calculated a pooled estimate that quantifies the magnitude of this risk across multiple studies.

Methods

We conducted a systematic review to identify longitudinal cohort studies containing data on the association between subthreshold depression and future major depression. A baseline meta-analysis was conducted using the inverse variance heterogeneity method to calculate the incidence rate ratio (IRR) of major depression among people with subthreshold depression relative to non-depressed controls. Subgroup analyses were conducted to investigate whether IRR estimates differed between studies categorised by age group or sample type. Sensitivity analyses were also conducted to test the robustness of baseline results to several sources of study heterogeneity, such as the case definition for subthreshold depression.

Results

Data from 16 studies (n = 67 318) revealed that people with subthreshold depression had an increased risk of developing major depression (IRR = 1.95, 95% confidence interval 1.28–2.97). Subgroup analyses estimated similar IRRs for different age groups (youth, adults and the elderly) and sample types (community-based and primary care). Sensitivity analyses demonstrated that baseline results were robust to different sources of study heterogeneity.

Conclusion

The results of this study support the scaling up of effective indicated prevention interventions for people with subthreshold depression, regardless of age group or setting.

Keywords

Incidencelongitudinal studiesmajor depressive disordermeta-analysisrisk factorssubthreshold depression
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 1 , January 2019 , pp. 92 - 102
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

†

Deceased on 4 June 2017.

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