Title Effectiveness of Psychological and Educational Interventions to Prevent Depression in Primary Care: A Systematic Review and Meta-Analysis
Authors Conejo-Ceron, Sonia, Moreno-Peral, Patricia, Rodriguez-Morejon, Alberto, MOTRICO MARTINEZ , EMMA, NAVAS CAMPAÑA, DESIRE MARÍA, RIGABERT SÁNCHEZ-JUNCO, ALINA, Martin-Perez, Carlos, Rodriguez-Bayon, Antonina, Isabel Ballesta-Rodriguez, Maria, de Dios Luna, Juan, Garcia-Campayo, Javier, Roca, Miquel, Angel Bellon, Juan, MOTRICO MARTINEZ , EMMA, RIGABERT SÁNCHEZ-JUNCO, ALINA, NAVAS CAMPAÑA, DESIRE MARÍA
External publication No
Means Ann. Fam. Med.
Scope Review
Nature Científica
JCR Quartile 1
SJR Quartile 1
JCR Impact 4.54000
SJR Impact 2.74800
Area International
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019100094&doi=10.1370%2fafm.2031&partnerID=40&md5=aa2f0a806afebe7631573dd9fe924a25
Publication date 01/05/2017
ISI 000402477900012
Scopus Id 2-s2.0-85019100094
DOI 10.1370/afm.2031
Abstract PURPOSE Although evidence exists for the efficacy of psychosocial interventions to prevent the onset of depression, little is known about its prevention in primary care. We aimed to evaluate the effectiveness of psychological and educational interventions to prevent depression in primary care. METHODS We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs) examining the effect of psychological and educational interventions to prevent depression in nondepressed primary care attendees. We searched MEDLINE, PsycINFO, Web of Science, OpenGrey Repository, Cochrane Central Register of Controlled Trials, and other sources up to May 2016. At least 2 reviewers independently evaluated the eligibility criteria, extracted data, and assessed the risk of bias. We calculated standardized mean differences (SMD) using random-effects models. RESULTS We selected 14 studies (7,365 patients) that met the inclusion criteria, 13 of which were valid to perform a meta-analysis. Most of the interventions had a cognitive-behavioral orientation, and in only 4 RCTs were the intervention clinicians primary care staff. The pooled SMD was -0.163 (95% CI, -0.256 to -0.070; P = .001). The risk of bias and the heterogeneity (I-2 = 20.6%) were low, and there was no evidence of publication bias. Meta-regression detected no association between SMD and follow-up times or SMD and risk of bias. Subgroup analysis suggested greater effectiveness when the RCTs used care as usual as the comparator compared with those using placebo. CONCLUSIONS Psychological and educational interventions to prevent depression had a modest though statistically significant preventive effect in primary care. Further RCTs using placebo or active comparators are needed.
Keywords depression/prevention & control; delivery of health care; primary health care; systematic review; meta-analysis; psychological interventions; educational interventions
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