Psychological interventions to prevent the onset of depressive disorders: A meta-analysis of randomized controlled trials

Pim Cuijpers; Blanca S Pineda; Soledad Quero; Eirini Karyotaki; Sascha Y Struijs; Caroline A Figueroa; Jazmin A Llamas; Toshi A Furukawa; Ricardo F Muñoz

doi:10.1016/j.cpr.2020.101955

Psychological interventions to prevent the onset of depressive disorders: A meta-analysis of randomized controlled trials

Clin Psychol Rev. 2021 Feb:83:101955. doi: 10.1016/j.cpr.2020.101955. Epub 2020 Dec 3.

Authors

Pim Cuijpers¹, Blanca S Pineda², Soledad Quero³, Eirini Karyotaki⁴, Sascha Y Struijs⁵, Caroline A Figueroa⁶, Jazmin A Llamas², Toshi A Furukawa⁷, Ricardo F Muñoz²

Affiliations

¹ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands. Electronic address: p.cuijpers@vu.nl.
² Institute for International Internet Interventions for Health (i4Health), Palo Alto University, United States.
³ Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain.
⁴ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Global Health and Social Medicine, Harvard Medical School, Boston, United States.
⁵ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Institute of Clinical Psychology, Leiden University, Leiden, the Netherlands.
⁶ School of Social Welfare, University of California Berkeley, United States.
⁷ Department of Health Promotion and Human Behavior, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan.

PMID: 33333441
DOI: 10.1016/j.cpr.2020.101955

Abstract

Purpose: Depressive disorders are common and have a considerable impact on patients and societies. Several treatments are available, but their effects are modest and reduce the burden only to a limited extent. Preventing the onset of depressive disorders may be one option to further reduce the global disease burden.

Methods: We conducted a meta-analysis of randomized controlled trials in participants without a diagnosis of depression at baseline, who were assigned to a preventive psychological intervention, or a care-as-usual, or comparable control group and in which incident cases of depression at follow-up were ascertained with a diagnostic interview.

Results: Our systematic searches resulted in 50 trials (14,665 participants) with relatively high quality, in high risk groups of all ages. The psychological interventions were mostly based on cognitive behavioral interventions. One year after the preventive interventions, the relative risk of developing a depressive disorder was RR = 0.81 (95% CI: 0.72-0.91), indicating that those who had received the intervention had 19% less chance to develop a depressive disorder. Given the average control event rate of 30%, twenty-one people had to participate in the intervention to prevent one depressive disorder compared to people in the control conditions.

Conclusions: Prevention is a promising approach to reduce the global disease burden of depression in addition to treatments.

Keywords: Cognitive behavior therapy; Depression; Interpersonal psychotherapy; Major depressive disorder; Meta-analysis; Prevention.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Cognitive Behavioral Therapy*
Depressive Disorder* / prevention & control
Humans
Psychosocial Intervention
Psychotherapy
Randomized Controlled Trials as Topic