Psychiatry International · Published 2026-06-01 · DOI 10.3390/psychiatryint7030118
Nanako Hanai, Satsuki Fujieda, Yuki Hongo, Kenichi Asano
Subthreshold depression (SD) is a significant risk factor for major depressive disorder. However, individuals with SD often do not seek professional help. This study aimed to identify a consensus-based list of self-help and “acts of kindness” (AK) strategies that are both helpful and feasible for individuals with SD while clarifying the perception gaps between clinical experts and individuals with lived experience. A three-round e-Delphi process was conducted with 51 clinical psychologists and 191 individuals with SD. The participants evaluated 187 initial strategies for helpfulness and feasibility using a 5-point Likert scale. After three rounds, five self-help strategies (e.g., “getting fresh air”) and one AK strategy reached a consensus for helpfulness. Conversely, 10 self-help and 11 AK strategies were endorsed for feasibility. A significant perception gap was identified: experts reported higher helpfulness than the SD panel, whereas the SD panel rated the feasibility of AK strategies significantly higher than the experts. These findings highlight a discrepancy between professional expectations and lived experience, suggesting that AK may serve as accessible, low-threshold options for mood improvement in clinical settings.
Abstract from DOAJ. Public domain (CC0 1.0).
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Hanai, N., Fujieda, S., Hongo, Y., et al. (2026). A Delphi Study to Identify Effective Self-Help and Kindness Strategies for Subthreshold Depression. Psychiatry International. https://doi.org/10.3390/psychiatryint7030118