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Title: Effectiveness of Psychological and Educational Interventions to Prevent Depression in Primary Care: A Systematic Review and Meta-Analysis.
Authors: Conejo-Cerón, Sonia
Moreno-Peral, Patricia
Rodríguez-Morejón, Alberto
Motrico, Emma
Navas-Campaña, Desirée
Rigabert, Alina
Martín-Pérez, Carlos
Rodríguez-Bayón, Antonina
Ballesta-Rodríguez, María Isabel
Luna, Juan de Dios
García-Campayo, Javier
Roca, Miquel
Bellón, Juan Ángel
Keywords: delivery of health care;depression/prevention & control;educational interventions;meta-analysis;primary health care;psychological interventions;systematic review
metadata.dc.subject.mesh: Depression
Primary Health Care
Randomized Controlled Trials as Topic
Issue Date: 2017
Abstract: 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. 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. 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. 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.
metadata.dc.identifier.doi: 10.1370/afm.2031
Appears in Collections:Producción 2020

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