Title Intervention to Prevent Major Depression in Primary Care A Cluster Randomized Trial
Authors Angel Bellon, Juan , Conejo-Ceron, Sonia , Moreno-Peral, Patricia , King, Michael , Nazareth, Irwin , Martin-Perez, Carlos , Fernandez-Alonso, Carmen , Rodriguez-Bayon, Antonina , Fernandez, Anna , Maria Aiarzaguena, Jose , Monton-Franco, Carmen , Ibanez-Casas, Inmaculada , Rodriguez-Sanchez, Emiliano , Isabel Ballesta-Rodriguez, Maria , Serrano-Blanco, Antoni , Cruz Gomez, Maria , LaFuente, Pilar , del Mar Munoz-Garcia, Maria , Minguez-Gonzalo, Pilar , Araujo, Luz , Palao, Diego , Bully, Paola , Zubiaga, Fernando , NAVAS CAMPAÑA, DESIRÉE MARÍA, Mendive, Juan , Manuel Aranda-Regules, Jose , Rodriguez-Morejon, Alberto , Salvador-Carulla, Luis , de Dios Luna, Juan
External publication Si
Means Ann. Intern. Med.
Scope Article
Nature Científica
JCR Quartile 1
SJR Quartile 1
JCR Impact 17.20200
SJR Impact 6.69400
Publication date 17/05/2016
ISI 000375878500013
DOI 10.7326/M14-2653
Abstract Background: Not enough is known about universal prevention of depression in adults.\n Objective: To evaluate the effectiveness of an intervention to prevent major depression.\n Design: Multicenter, cluster randomized trial with sites randomly assigned to usual care or an intervention. (ClinicalTrials.gov:NCT01151982)\n Setting: 10 primary care centers in each of 7 cities in Spain.\n Participants: Two primary care physicians (PCPs) and 5236 nondepressed adult patients were randomly sampled from each center; 3326 patients consented and were eligible to participate.\n Intervention: For each patient, PCPs communicated individual risk for depression and personal predictors of risk and developed a psychosocial program tailored to prevent depression.\n Measurements: New cases of major depression, assessed every 6 months for 18 months.\n Results: At 18 months, 7.39% of patients in the intervention group (95% CI, 5.85% to 8.95%) developed major depression compared with 9.40% in the control (usual care) group (CI, 7.89% to 10.92%) (absolute difference, -2.01 percentage points [CI, -4.18 to 0.16 percentage points]; P = 0.070). Depression incidence was lower in the intervention centers in 5 cities and similar between intervention and control centers in 2 cities.\n Limitation: Potential self-selection bias due to nonconsenting patients.\n Conclusion: Compared with usual care, an intervention based on personal predictors of risk for depression implemented by PCPs provided a modest but nonsignificant reduction in the incidence of major depression. Additional study of this approach may be warranted.
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