Universal depression prevention: An umbrella review of meta-analyses

Erin Hoare; Sam Collins; Wolfgang Marx; Edward Callaly; Ryan Moxham-Smith; Pim Cuijpers; Arne Holte; Andrew A Nierenberg; Nicola Reavley; Helen Christensen; Charles F Reynolds 3rd; Andre F Carvalho; Felice Jacka; Michael Berk

doi:10.1016/j.jpsychires.2021.10.006

Universal depression prevention: An umbrella review of meta-analyses

J Psychiatr Res. 2021 Dec:144:483-493. doi: 10.1016/j.jpsychires.2021.10.006. Epub 2021 Oct 16.

Authors

Affiliations

¹ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia. Electronic address: erin.hoare1@deakin.edu.au.
² Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.
³ Department of Clinical, Neuro and Developmental Psychology, Centre for Mental Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
⁴ Department of Psychology, University of Oslo, Norwegian Institute of Public Health, Norway.
⁵ Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Harvard Medical School, USA.
⁶ Melbourne School of Population and Global Health, The University of Melbourne, Australia.
⁷ Black Dog Institute and UNSW, Australia.
⁸ University of Pittsburgh Graduate School of Medicine and Graduate School of Public Health, Mindstrong, Palo Alto, CA, USA.
⁹ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre of Addiction and Mental Health (CAMH), Toronto, ON, Canada.
¹⁰ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia; Black Dog Institute, Sydney, Australia.
¹¹ Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Florey Institute for Neuroscience and Mental Health, Melbourne, Australia.

PMID: 34768070
DOI: 10.1016/j.jpsychires.2021.10.006

Abstract

Depression is a disabling, highly prevalent, frequently chronic, and difficult-to-treat disorder with an immense cognitive, social, and economic burden. Given that many of the advances in other non-communicable disorders like cancer have been in prevention rather than treatment, the prevention of depression is currently an unmet public health priority. We sought to provide an overview of the meta-analytic literature through conducting a systematic umbrella review of universally delivered preventive interventions for depression. The search was conducted on March 18, 2021 utilising the following databases (all accessed through EBSCOHost); Allied and Complementary Medicine Database, CINAHL Complete, Global Health, Health Source: Nursing/Academic Edition, MEDLINE Complete and APA PsychArticles. The following search terms related to depression, prevention, and trial study design. Two authors independently screened articles and a third resolved discrepancies. Eligibility criteria sought to identify meta-analyses that investigated the prevention of depression (i.e., reduced incidence) through intervention studies that were universal, in that they were designed to be delivered to entire populations Six meta-analyses on psychological interventions, two school-based meta-analyses, and one eHealth meta-analysis were included in this umbrella review. Findings indicated that all identified studies were of good quality and one was of fair quality. One previous meta-review that examined physical activity to prevent depression was included in results, comprising eight meta-analyses. Preventive interventions have primarily and successfully utilized psychological therapeutic components, delivered at the school, community, and workplace settings. Both school- and eHealth-based interventions hold some utility for depression prevention. There is meta-analytic evidence that physical activity is efficacious for depression prevention. However, universal prevention is inconsistently defined. There is a pressing need for well-designed randomized controlled preventative interventions for depression before recommendations can be universally accepted with convincing level of evidence.

Keywords: Depression; Interventions; Lifespan; Population health; Prevention; Universal.

Publication types

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

MeSH terms

Depression* / epidemiology
Depression* / prevention & control
Exercise*
Humans
Meta-Analysis as Topic