Sonia Conejo-Cerón1, Patricia Moreno-Peral2, Alberto Rodríguez-Morejón2, Emma Motrico2, Desirée Navas-Campaña2, Alina Rigabert2, Carlos Martín-Pérez2, Antonina Rodríguez-Bayón2, María Isabel Ballesta-Rodríguez2, Juan de Dios Luna2, Javier García-Campayo2, Miquel Roca2, Juan Ángel Bellón2. 1. Unidad de Investigación, Distrito de Atención Primaria Málaga-Guadalhorce, Málaga, Spain (Conejo-Cerón, Moreno-Peral, Navas-Campaña, Bellón); Red de Investigación en Actividades Preventivas y de Promoción de la Salud (redIAPP), Barcelona, Spain (Conejo-Cerón, Moreno-Peral, Rodríguez-Morejón, Motrico, Navas-Campaña, Rigabert, Martín-Pérez, Rodríguez-Bayón, Ballesta-Rodríguez, Luna, García-Campayo, Roca, Bellón); Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain (Conejo-Cerón, Moreno-Peral, Rodríguez-Morejón, Bellón); Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Malaga, Spain (Rodríguez-Morejón); Departamento de Psicología, Universidad Loyola Andalucía, Sevilla, Spain (Motrico, Rigabert); Centro de Salud Marquesado, Área Nordeste de Granada, Granada, Spain (Martín-Pérez); Centro de Salud San José, Linares, Jaén, Spain (Rodríguez-Bayón); Centro de Salud Federico del Castillo, Jaén, Spain (Ballesta-Rodríguez); Departamento de Bioestadística. Universidad de Granada, Granada, Spain (Luna); Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain (Luna); Departamento de Psiquiatría, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain (García-Campayo); Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain (Roca); Centro de Salud El Palo, Málaga, Spain (Bellón); Departamento de Medicina Preventiva, Salud Pública y Psiquiatría, Universidad de Málaga, Málaga, Spain (Bellón). soniafundacionimabis@hotmail.com. 2. Unidad de Investigación, Distrito de Atención Primaria Málaga-Guadalhorce, Málaga, Spain (Conejo-Cerón, Moreno-Peral, Navas-Campaña, Bellón); Red de Investigación en Actividades Preventivas y de Promoción de la Salud (redIAPP), Barcelona, Spain (Conejo-Cerón, Moreno-Peral, Rodríguez-Morejón, Motrico, Navas-Campaña, Rigabert, Martín-Pérez, Rodríguez-Bayón, Ballesta-Rodríguez, Luna, García-Campayo, Roca, Bellón); Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain (Conejo-Cerón, Moreno-Peral, Rodríguez-Morejón, Bellón); Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Malaga, Spain (Rodríguez-Morejón); Departamento de Psicología, Universidad Loyola Andalucía, Sevilla, Spain (Motrico, Rigabert); Centro de Salud Marquesado, Área Nordeste de Granada, Granada, Spain (Martín-Pérez); Centro de Salud San José, Linares, Jaén, Spain (Rodríguez-Bayón); Centro de Salud Federico del Castillo, Jaén, Spain (Ballesta-Rodríguez); Departamento de Bioestadística. Universidad de Granada, Granada, Spain (Luna); Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain (Luna); Departamento de Psiquiatría, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain (García-Campayo); Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands, Palma de Mallorca, Spain (Roca); Centro de Salud El Palo, Málaga, Spain (Bellón); Departamento de Medicina Preventiva, Salud Pública y Psiquiatría, Universidad de Málaga, Málaga, Spain (Bellón).
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 (I2 = 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.
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 (I2 = 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.
Authors: Kim van Zoonen; Claudia Buntrock; David Daniel Ebert; Filip Smit; Charles F Reynolds; Aartjan T F Beekman; Pim Cuijpers Journal: Int J Epidemiol Date: 2014-04 Impact factor: 7.196
Authors: Frances L Lynch; Mark Hornbrook; Gregory N Clarke; Nancy Perrin; Michael R Polen; Elizabeth O'Connor; John Dickerson Journal: Arch Gen Psychiatry Date: 2005-11
Authors: Juan Ángel Bellón; Patricia Moreno-Peral; Emma Motrico; Alberto Rodríguez-Morejón; Ana Fernández; Antoni Serrano-Blanco; Edurne Zabaleta-del-Olmo; Sonia Conejo-Cerón Journal: Prev Med Date: 2014-11-20 Impact factor: 4.018
Authors: Pim Cuijpers; Nicole Vogelzangs; Jos Twisk; Annet Kleiboer; Juan Li; Brenda W Penninx Journal: Am J Psychiatry Date: 2014-04 Impact factor: 18.112
Authors: Michael King; Irwin Nazareth; Gus Levy; Carl Walker; Richard Morris; Scott Weich; Juan Angel Bellón-Saameño; Berta Moreno; Igor Svab; Danica Rotar; J Rifel; Heidi-Ingrid Maaroos; Anu Aluoja; Ruth Kalda; Jan Neeleman; Mirjam I Geerlings; Miguel Xavier; Manuel Caldas de Almeida; Bernardo Correa; Francisco Torres-Gonzalez Journal: Br J Psychiatry Date: 2008-05 Impact factor: 9.319
Authors: R F Muñoz; Y W Ying; G Bernal; E J Pérez-Stable; J L Sorensen; W A Hargreaves; J Miranda; L S Miller Journal: Am J Community Psychol Date: 1995-04
Authors: Maria Rubio-Valera; Mariona Pons-Vigués; María Martínez-Andrés; Patricia Moreno-Peral; Anna Berenguera; Ana Fernández Journal: PLoS One Date: 2014-02-28 Impact factor: 3.240
Authors: Patricia Moreno-Peral; Sonia Conejo-Cerón; Maria Rubio-Valera; Anna Fernández; Desirée Navas-Campaña; Alberto Rodríguez-Morejón; Emma Motrico; Alina Rigabert; Juan de Dios Luna; Carlos Martín-Pérez; Antonina Rodríguez-Bayón; María Isabel Ballesta-Rodríguez; Juan Vicente Luciano; Juan Ángel Bellón Journal: JAMA Psychiatry Date: 2017-10-01 Impact factor: 21.596
Authors: Tracy Gladstone; Daniela Terrizzi; Allison Stinson; Jennifer Nidetz; Jason Canel; Eumene Ching; Anita Berry; James Cantorna; Joshua Fogel; Milton Eder; Megan Bolotin; Lauren O Thomann; Kathy Griffith; Patrick Ip; David A Aaby; C Hendricks Brown; William Beardslee; Carl Bell; Theodore J Crawford; Marian Fitzgibbon; Linda Schiffer; Nina Liu; Monika Marko-Holguin; Benjamin W Van Voorhees Journal: JAMA Netw Open Date: 2018-11
Authors: Alina Rigabert; Emma Motrico; Patricia Moreno-Peral; Davinia M Resurrección; Sonia Conejo-Cerón; Desirée Navas-Campaña; Juan Á Bellón Journal: BMJ Open Date: 2018-11-28 Impact factor: 2.692
Authors: Patricia Moreno-Peral; Sonia Conejo-Cerón; Anna Fernández; Carlos Martín-Pérez; Carmen Fernández-Alonso; Antonina Rodríguez-Bayón; María Isabel Ballesta-Rodríguez; José María Aiarzagüena; Carmen Montón-Franco; Michael King; Irwin Nazareth; Juan Ángel Bellón Journal: PLoS One Date: 2019-05-30 Impact factor: 3.240
Authors: Anna Fernández; Juan M Mendive; Sonia Conejo-Cerón; Patricia Moreno-Peral; Michael King; Irwin Nazareth; Carlos Martín-Pérez; Carmen Fernández-Alonso; Antonina Rodríguez-Bayón; Jose Maria Aiarzaguena; Carmen Montón-Franco; Antoni Serrano-Blanco; Inmaculada Ibañez-Casas; Emiliano Rodríguez-Sánchez; Luis Salvador-Carulla; Paola Bully Garay; María Isabel Ballesta-Rodríguez; Pilar LaFuente; María Del Mar Muñoz-García; Pilar Mínguez-Gonzalo; Luz Araujo; Diego Palao; María Cruz Gómez; Fernando Zubiaga; Desirée Navas-Campaña; Jose Manuel Aranda-Regules; Alberto Rodriguez-Morejón; Juan de Dios Luna; Juan Ángel Bellón Journal: BMC Med Date: 2018-02-23 Impact factor: 8.775
Authors: Tracy Gladstone; Katherine R Buchholz; Marian Fitzgibbon; Linda Schiffer; Miae Lee; Benjamin W Van Voorhees Journal: Int J Environ Res Public Health Date: 2020-10-22 Impact factor: 3.390