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Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both

  • Pirn Cuijpers (a1), Nicole Vogelzangs (a2), Jos Twisk (a3), Annet Kleiboer (a4), Juan Li (a5) and Brenda W. Penninx (a6)...



Although the association between depression and excess mortality has been well established, it is not clear whether this is greater in major depression than in subthreshold depression.


To compare excess mortality in major depression with that in subthreshold depression.


We searched bibliographic databases and included prospective studies in which both major and subthreshold depression were examined at baseline and mortality was measured at follow-up.


A total of 22 studies were included. People with major depression had a somewhat increased chance of dying earlier than people with subthreshold depression but this difference was not significant, although there was a trend (relative risk 1.13, 95% CI 0.98-1.30, P=0.1). The population attributable fraction was 7% for major depression and an additional 7% for subthreshold depression.


Although excess mortality may be somewhat higher in major than in subthreshold depression, the difference is small and the overall impact on excess mortality is comparable.

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Corresponding author

Professor Pim Cuijpers, Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1,1081 BT Amsterdam, The Netherlands. Email:


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Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both

  • Pirn Cuijpers (a1), Nicole Vogelzangs (a2), Jos Twisk (a3), Annet Kleiboer (a4), Juan Li (a5) and Brenda W. Penninx (a6)...


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Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both

  • Pirn Cuijpers (a1), Nicole Vogelzangs (a2), Jos Twisk (a3), Annet Kleiboer (a4), Juan Li (a5) and Brenda W. Penninx (a6)...
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