Title Effectiveness of universal multiple-risk lifestyle interventions in reducing depressive symptoms: Systematic review and meta-analysis
Authors GÓMEZ GÓMEZ, IRENE, Bellon, Juan A. , RESURRECCIÓN MENA, DAVINIA MARÍA, Cuijpers, Pim , Moreno-Peral, Patricia , Rigabert, Alina , Angel Maderuelo-Fernandez, Jose , MOTRICO MARTINEZ, EMMA
External publication No
Scope Article
Nature Científica
JCR Quartile 1
SJR Quartile 1
JCR Impact 4.018
SJR Impact 1.628
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85082191852&doi=10.1016%2fj.ypmed.2020.106067&partnerID=40&md5=3d8962bc86f388ede0b89de3f8a0dde8
Publication date 01/05/2020
ISI 000525917600020
Scopus Id 2-s2.0-85082191852
DOI 10.1016/j.ypmed.2020.106067
Abstract Though many studies have explored the association between single-risk\n lifestyle interventions and depression, unhealthy lifestyle factors\n often co-occur, with adults engaging in two or more risk behaviours. To\n date, little is known about the effectiveness of universal multiple-risk\n lifestyle interventions to reduce depressive symptoms. We conducted a\n SR/MA to assess the effectiveness of universal multiple-risk lifestyle\n interventions (by promoting a healthy diet, physical activity and/or\n smoking cessation) to reduce depressive symptoms in adults. We searched\n MEDLINE, Scopus, CENTRAL, PsycINFO, WOS, OpenGrey, the ICTRP and other\n sources from inception to 16 September 2019. We selected only randomized\n controlled trials, with no restrictions on language or setting. Our\n outcome was the reduction of depressive symptoms. We calculated the\n standardized mean difference using random-effect models. Sensitivity,\n sub-group and meta-regression analyses were performed. Of the 9386\n abstracts reviewed, 311 were selected for full-text review. Of these, 23\n RCTs met the inclusion criteria, including 7558 patients from four\n continents. Twenty RCTs provided valid data for inclusion in the\n meta-analysis. The pooled SMD was -0.184 (95% CI, -0.311 to -0.057; p =\n 0.005). We found no publication bias, but heterogeneity was substantial\n (I-2 = 72%; 95% CI: 56% to 82%). The effectiveness disappeared when only\n studies with a low risk of bias were included. The quality of evidence\n according GRADE was low. Although a small preventive effect was found,\n the substantial heterogeneity and RCTs with lower risk of bias suggested\n no effectiveness of universal multiple-risk lifestyle interventions in\n reducing depressive symptoms in a varied adult population. Further\n evidence is required.
Keywords Lifestyle risk reduction; Depression symptoms reduction; Systematic review; Meta-analysis
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