Title Effectiveness of Psychological and/or Educational Interventions in the Prevention of Anxiety A Systematic Review, Meta-analysis, and Meta-regression
Authors Moreno-Peral, Patricia, Conejo-Ceron, Sonia, Rubio-Valera, Maria, Fernandez, Anna, NAVAS CAMPAÑA, DESIRE MARÍA, Rodriguez-Morejon, Alberto, MOTRICO MARTINEZ , EMMA, RIGABERT SÁNCHEZ-JUNCO, ALINA, de Dios Luna, Juan, Martin-Perez, Carlos, Rodriguez-Bayon, Antonina, Isabel Ballesta-Rodriguez, Maria, Vicente Luciano, Juan, Angel Bellon, Juan, MOTRICO MARTINEZ , EMMA, RIGABERT SÁNCHEZ-JUNCO, ALINA, NAVAS CAMPAÑA, DESIRE MARÍA
External publication No
Means JAMA Psychiatry
Scope Article
Nature Científica
JCR Quartile 1
SJR Quartile 1
JCR Impact 16.64200
SJR Impact 8.09700
Area International
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85030637434&doi=10.1001%2fjamapsychiatry.2017.2509&partnerID=40&md5=14a8ac54b8cf0fb408a1c861c5b7deef
Publication date 01/10/2017
ISI 000412386900007
Scopus Id 2-s2.0-85030637434
DOI 10.1001/jamapsychiatry.2017.2509
Abstract IMPORTANCE To our knowledge, no systematic reviews or meta-analyses have been conducted to assess the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. OBJECTIVE To evaluate the effectiveness of preventive psychological and/or educational interventions for anxiety in varied population types. DATA SOURCES A systematic review and meta-analysis was conducted based on literature searches of MEDLINE, PsycINFO, Web of Science, EMBASE, OpenGrey, Cochrane Central Register of Controlled Trials, and other sources from inception to March 7, 2017. STUDY SELECTION A search was performed of randomized clinical trials assessing the effectiveness of preventive psychological and/or educational interventions for anxiety in varying populations free of anxiety at baseline as measured using validated instruments. There was no setting or language restriction. Eligibility criteria assessment was conducted by 2 of us. DATA EXTRACTION AND SYNTHESIS Data extraction and assessment of risk of bias (Cochrane Collaboration's tool) were performed by 2 of us. Pooled standardized mean differences (SMDs) were calculated using random-effect models. Heterogeneity was explored by random-effects meta-regression. MAIN OUTCOMES AND MEASURES Incidence of new cases of anxiety disorders or reduction of anxiety symptoms as measured by validated instruments. RESULTS Of the 3273 abstracts reviewed, 131 were selected for full-text review, and 29 met the inclusion criteria, representing 10 430 patients from 11 countries on 4 continents. Meta-analysis calculations were based on 36 comparisons. The pooled SMD was -0.31 (95% CI, -0.40 to -0.21; P < .001) and heterogeneity was substantial (I-2 = 61.1%; 95% CI, 44% to 73%). There was evidence of publication bias, but the effect size barely varied after adjustment (SMD, -0.27; 95% CI, -0.37 to -0.17; P < .001). Sensitivity analyses confirmed the robustness of effect size results. Ameta-regression including 5 variables explained 99.6% of between-study variability, revealing an association between higher SMD, waiting list (comparator) (beta = -0.33 [95% CI, -0.55 to -0.11]; P = .005) and a lower sample size (lg) (beta = 0.15 [95% CI, 0.06 to 0.23]; P = .001). No association was observed with risk of bias, family physician providing intervention, and use of standardized interviews as outcomes. CONCLUSIONS AND RELEVANCE Psychological and/or educational interventions had a small but statistically significant benefit for anxiety prevention in all populations evaluated. Although more studies with larger samples and active comparators are needed, these findings suggest that anxiety prevention programs should be further developed and implemented.
Keywords anxiety disorder; Article; Cochrane Library; Embase; human; information retrieval; Medline; meta analysis; outcome assessment; psychoeducation; psychotherapy; PsycINFO; risk assessment; systematic rev
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