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.

中文翻译：

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预防抑郁症发作的心理干预：随机对照试验的荟萃分析

目的

抑郁症很常见，对患者和社会有相当大的影响。有几种治疗方法可用，但它们的效果不大，只能在有限的程度上减轻负担。预防抑郁症的发作可能是进一步减轻全球疾病负担的一种选择。

方法

我们对基线时未诊断出抑郁症的参与者进行了一项随机对照试验的荟萃分析，这些参与者被分配到预防性心理干预组、照常护理组或可比较的对照组，其中随后出现抑郁症病例-up 是通过诊断性访谈确定的。

结果

我们的系统搜索产生了 50 项质量相对较高的试验（14,665 名参与者），涉及所有年龄段的高危人群。心理干预主要基于认知行为干预。预防性干预一年后，患抑郁症的相对风险为 RR = 0.81（95% CI：0.72–0.91），表明接受干预的人患抑郁症的几率降低了 19%。鉴于平均控制事件率为 30%，与控制条件下的人相比，有 21 人必须参与干预以预防一种抑郁症。

结论

除了治疗之外，预防是减轻抑郁症全球疾病负担的一种很有前景的方法。