Harrer, MathiasMathiasHarrerSprenger, Antonia AAntonia ASprengerIlling, SusanSusanIllingAdriaanse, Marcel CMarcel CAdriaanseAlbert, Steven MSteven MAlbertAllart, EstherEstherAllartAlmeida, Osvaldo POsvaldo PAlmeidaBasanovic, JulianJulianBasanovicvan Bastelaar, Kim M PKim M Pvan BastelaarBatterham, Philip JPhilip JBatterhamBaumeister, HaraldHaraldBaumeisterBerger, ThomasThomasBerger0000-0002-2432-7791Blanco, VanessaVanessaBlancoBø, RagnhildRagnhildBøCasten, Robin JRobin JCastenChan, DickenDickenChanChristensen, HelenHelenChristensenCiharova, MarketaMarketaCiharovaCook, LornaLornaCookCornell, JohnJohnCornellDavis, Elysia PElysia PDavisDobson, Keith SKeith SDobsonDozeman, ElsienElsienDozemanGilbody, SimonSimonGilbodyHankin, Benjamin LBenjamin LHankinHaringsma, RimkeRimkeHaringsmaHoorelbeke, KristofKristofHoorelbekeIrwin, Michael RMichael RIrwinJansen, FemkeFemkeJansenJonassen, RuneRuneJonassenKaryotaki, EiriniEiriniKaryotakiKawakami, NoritoNoritoKawakamiKlein, J PhilippJ PhilippKleinKonnert, CandaceCandaceKonnertImamura, KotaroKotaroImamuraLandrø, Nils IngeNils IngeLandrøLara, María AsunciónMaría AsunciónLaraLe, Huynh-NhuHuynh-NhuLeLehr, DirkDirkLehrLuciano, Juan VJuan VLucianoMoritz, SteffenSteffenMoritzMossey, Jana MJana MMosseyMuñoz, Ricardo FRicardo FMuñozMuntingh, AnnaAnnaMuntinghNobis, StephanieStephanieNobisOlmstead, RichardRichardOlmsteadOtero, PatriciaPatriciaOteroPibernik-Okanović, MirjanaMirjanaPibernik-OkanovićPot, Anne MargrietAnne MargrietPotReynolds, Charles FCharles FReynoldsRovner, Barry WBarry WRovnerSanabria-Mazo, Juan PJuan PSanabria-MazoSander, Lasse BLasse BSanderSmit, FilipFilipSmitSnoek, Frank JFrank JSnoekSpek, ViolaViolaSpekSpinhoven, PhilipPhilipSpinhovenStelmach, LizaLizaStelmachTerhorst, YannikYannikTerhorstVázquez, Fernando LFernando LVázquezLeeuw, Irma Verdonck-deIrma Verdonck-deLeeuwWatkins, EdEdWatkinsYang, WenhuiWenhuiYangWong, Samuel Yeung ShanSamuel Yeung ShanWongZimmermann, JohannesJohannesZimmermannSakata, MasatsuguMasatsuguSakataFurukawa, Toshi AToshi AFurukawaLeucht, StefanStefanLeuchtCuijpers, PimPimCuijpersBuntrock, ClaudiaClaudiaBuntrockEbert, David DanielDavid DanielEbert2025-05-302025-05-302025-05-14https://boris-portal.unibe.ch/handle/20.500.12422/211189Background 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.enMeta-analysisdepressive disordersprecision medicinepreventionpsychological treatments100 - Philosophy::150 - Psychologyarticle10.48620/883254036598010.1192/bjp.2025.56