[Subdiagnostic depression. Are there treatments with clinically relevant effects?]

Minor depression, subsyndromal depression and subthreshold depression are frequent conditions in primary care which do not fulfil the criteria of a depressive disorder but are associated with functional disability, impairment of quality of life, and health care use. This paper reviews studies on the clinical evidence of pharmacotherapy, psychotherapy, and interventions to improve primary care. In this regard, whether clinical relevance of antidepressant therapies can be concluded from differences between placebo and active treatment is critically discussed. Due to lacking clinical evidence, aspects of a pragmatic therapeutic approach in those patients are presented.