Primary prevention of depression: An umbrella review of controlled interventions
- Forfatter(e)
- Salazar de Pablo, G. Solmi, M. Vaquerizo-Serrano, J. Radua, J. Passina, A. Morsillo, P. Correll, C. U. Borgwardt, S. Galderisi, S. Bechdolf, A. Pfennig, A. Bauer, M. Kessing, L. V. van Amelsvoort, T. Nieman, D. H. Domschke, K. Krebs, M. O. Sand, M. Vieta, E. McGuire, P. Arango, C. Shin, J. I. Fusar-Poli, P.
- År
- 2021
- Tidsskrift
- Journal of Affective Disorders
- Sider
- 957-970
- Kategori(er)
- Depresjon og nedstemthet (inkl. både vansker og lidelse)
- Tiltakstype(r)
- Abstract
Background: : Primary prevention has the potential to modify the course of depression, but the consistency and magnitude of this effect are currently undetermined.
Method(s): PRISMA and RIGHT compliant (PROSPERO: CRD42020179659) systematic meta-review, PubMed/Web of Science, up to June 2020. Meta-analyses of controlled interventions for the primary prevention of depressive symptoms [effect measures: standardized mean difference (SMD)] or depressive disorders [effect measure: relative risk (RR)] were carried out. Results were stratified by: (i) age range; (ii) target population (general and/or at-risk); (iii) intervention type. Quality (assessed with AMSTAR/AMSTAR-PLUS content) and credibility (graded as high/moderate/low) were assessed. USPSTF grading system was used for recommendations.
Result(s): Forty-six meta-analyses (k=928 individual studies, n=286,429 individuals, mean age=22.4 years, 81.1% female) were included. Effect sizes were: SMD=0.08-0.53; for depressive symptoms; RR=0.90-0.28 for depressive disorders. Sensitivity analyses including only RCTs did not impact the findings. AMSTAR median=9 (IQR=8-9); AMSTAR-PLUS content median=4.25 (IQR=4-5). Credibility of the evidence was insufficient/low in 43 (93.5%) meta-analyses, moderate in two (4.3%), and high in one (2.2%): reduction of depressive symptoms using psychosocial interventions for young adults only, and a combination of psychological and educational interventions in primary care had moderate credibility; preventive administration of selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in individuals with a stroke had high credibility. Limitation(s): Intervention heterogeneity and lack of long-term efficacy evaluation.
Conclusion(s): Primary preventive interventions for depression might be effective. Among them, clinicians may offer SSRIs post-stroke to prevent depressive disorders, and psychosocial interventions for children/adolescents/young adults with risk factors or during the prenatal/perinatal period. Copyright © 2021 The Authors