Author(s): Posternak MA, Miller I
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Abstract INTRODUCTION: While the short-term response rates to antidepressant medication and placebo are well established, very little is known about the short-term course of untreated depression. Knowledge of the course of untreated depression can serve as a benchmark for assessing the true benefits of active treatment. METHOD: A meta-analysis was performed analyzing the outcomes of all psychotherapy studies that randomized adult outpatients with major depressive disorder to a wait-list control group. RESULTS: Nineteen studies involving 221 subjects were reviewed. The mean decrease in Hamilton Rating Scale for Depression scores over 2-20 weeks was 11.9\%, while the mean decrease in Beck Depression Inventory scores was 15.7\%. Using a subsample of studies that reported individual outcomes, we estimated that 15 of 76 subjects (19.7\%) improved to a degree comparable to what would be considered a positive response in antidepressant trials. CONCLUSIONS: In the short-term, depressive symptomatology can be expected to decrease by about 10-15\% on average without treatment. As many as 20\% of subjects who participate in a short-term antidepressant trial may experience a spontaneous remission.
This article was published in J Affect Disord
and referenced in Journal of Psychology & Psychotherapy