{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:53:25Z","timestamp":1790042005389,"version":"4.0.1"},"reference-count":48,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec id=\"S000712502500056X_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has\u00a0on symptom deterioration, response and remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500056X_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500056X_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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\u2013covariate 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500056X_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      IPD of 10\u00a0671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = \u22120.48 to \u22120.27). Effects could not be ascertained up to 24 months (s.m.d. = \u22120.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27\u20132.79), reliable improvement (relative risk = 1.38\u20133.17), deterioration (relative risk = 0.67\u20130.54) and close-to-symptom-free status (relative risk = 1.41\u20132.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = \u22120.33 for PHQ-9 = 5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500056X_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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 \u2265 10. For very mild symptoms, scalable treatments could be an attractive option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.56","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T07:46:28Z","timestamp":1747208788000},"page":"78-91","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Psychological intervention in individuals with subthreshold depression: individual participant data meta-analysis of treatment effects and moderators"],"prefix":"10.1192","volume":"229","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7016-2687","authenticated-orcid":false,"given":"Mathias","family":"Harrer","sequence":"first","affiliation":[{"name":"Vrije Universiteit Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia A.","family":"Sprenger","sequence":"additional","affiliation":[{"name":"Otto-von-Guericke-University Magdeburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Illing","sequence":"additional","affiliation":[{"name":"Technical University of Munich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel C.","family":"Adriaanse","sequence":"additional","affiliation":[{"name":"Vrije Universiteit Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Albert","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Allart","sequence":"additional","affiliation":[{"name":"Allart Supervisie"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvaldo P.","family":"Almeida","sequence":"additional","affiliation":[{"name":"University of Western Australia"},{"name":"University of Notre Dame Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Basanovic","sequence":"additional","affiliation":[{"name":"University of Exeter"},{"name":"University of Western Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M. 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