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JOURNAL OF AFFECTIVE DISORDERS
Volume 66, Issue 2-3, Pages 139-146Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/S0165-0327(00)00304-9
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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-fist 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. (C) 2001 Elsevier Science B.V. All rights reserved.
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