Although efforts have been undertaken to determine how psychological interventions exert their effects, research on mediators and mechanisms of change remains limited, especially in the field of prevention. We aimed to assess available evidence on mediators of psychological and psychoeducational interventions for the prevention of depression and anxiety in varied populations. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and the Cochrane Central Register of Controlled Trials was performed. Two independent reviewers assessed the eligibility criteria of all articles, extracted data, determined the risk of bias in randomized controlled trials, and the requirements for mediators. The outcomes were mediators of the incidence of depression or anxiety and/or the reduction of symptoms of depression or anxiety. We identified 28 nested mediator studies within randomized controlled trials involving 7442 participants. Potential cognitive, behavioral, emotional and interpersonal mediators were evaluated in different psychological and psychoeducational interventions to prevent depression and anxiety. The effects were mediated mainly by cognitive variables, which were the most commonly assessed factors. For depression, the mediator with the strongest empirical support was negative thinking in adults. Cognitive change is an important mediator in preventive psychological and psychoeducational interventions for both anxiety and depression.

Registration details

Registration number (PROSPERO): CRD42018092393.

中文翻译：

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心理和心理教育干预措施的调解人，用于预防抑郁和焦虑。系统的审查。

尽管已作出努力确定心理干预如何发挥作用，但对调解者和变化机制的研究仍然有限，特别是在预防领域。我们旨在评估有关预防各种人群抑郁和焦虑的心理和心理教育干预手段的现有证据。使用PubMed，PsycINFO，Web of Science，Embase，OpenGrey和Cochrane对照试验中央注册系统进行了系统评价。两名独立的审稿人评估了所有文章的资格标准，提取了数据，确定了随机对照试验中存在偏见的风险以及对调解员的要求。结果是抑郁或焦虑的发生和/或抑郁或焦虑症状的减轻的中介。我们在涉及7442名参与者的随机对照试验中确定了28项巢式介体研究。在不同的心理和心理教育干预措施中，对潜在的认知，行为，情感和人际交往者进行了评估，以预防抑郁症和焦虑症。影响主要由认知变量介导，认知变量是最常评估的因素。对于抑郁症，经验支持最强的中介者是成年人的消极思想。认知变化是预防焦虑和抑郁的心理和心理教育干预措施的重要中介。在不同的心理和心理教育干预措施中对情绪和人际交往者进行了评估，以预防抑郁和焦虑。影响主要由认知变量介导，认知变量是最常评估的因素。对于抑郁症，经验支持最强的中介者是成年人的消极思想。认知变化是预防焦虑和抑郁的心理和心理教育干预措施的重要中介。在不同的心理和心理教育干预措施中对情绪和人际交往者进行了评估，以预防抑郁和焦虑。影响主要由认知变量介导，认知变量是最常评估的因素。对于抑郁症，经验支持最强的中介者是成年人的消极思想。认知变化是预防焦虑和抑郁的心理和心理教育干预措施的重要中介。

报名详情

注册号（PROSPERO）：CRD42018092393。