Primary prevention of depression: An umbrella review of controlled interventions.

Adolescent Adult Child Depression Female Humans Male Primary Health Care Primary Prevention Selective Serotonin Reuptake Inhibitors Young Adult
Depression Prevention, Evidence, Prediction, Meta-analysis

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 11 2021
Historique:
received: 13 04 2021
revised: 14 07 2021
accepted: 26 07 2021
pubmed: 11 8 2021
medline: 30 10 2021
entrez: 10 8 2021
Statut: ppublish

Résumé

Primary prevention has the potential to modify the course of depression, but the consistency and magnitude of this effect are currently undetermined. PRISMA and RIGHT compliant (PROSPERO:CRD42020179659) systematic meta-review, PubMed/Web of Science, up to June 2020. Meta-analyses of controlled interventions for the primary prevention of depressive symptoms [effect measures: standardized mean difference (SMD)] or depressive disorders [effect measure: relative risk (RR)] were carried out. Results were stratified by: (i) age range; (ii) target population (general and/or at-risk); (iii) intervention type. Quality (assessed with AMSTAR/AMSTAR-PLUS content) and credibility (graded as high/moderate/low) were assessed. USPSTF grading system was used for recommendations. Forty-six meta-analyses (k=928 individual studies, n=286,429 individuals, mean age=22.4 years, 81.1% female) were included. Effect sizes were: SMD=0.08-0.53; for depressive symptoms; RR=0.90-0.28 for depressive disorders. Sensitivity analyses including only RCTs did not impact the findings. AMSTAR median=9 (IQR=8-9); AMSTAR-PLUS content median=4.25 (IQR=4-5). Credibility of the evidence was insufficient/low in 43 (93.5%) meta-analyses, moderate in two (4.3%), and high in one (2.2%): reduction of depressive symptoms using psychosocial interventions for young adults only, and a combination of psychological and educational interventions in primary care had moderate credibility; preventive administration of selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in individuals with a stroke had high credibility. Intervention heterogeneity and lack of long-term efficacy evaluation. Primary preventive interventions for depression might be effective. Among them, clinicians may offer SSRIs post-stroke to prevent depressive disorders, and psychosocial interventions for children/adolescents/young adults with risk factors or during the prenatal/perinatal period.

Sections du résumé

BACKGROUND
Primary prevention has the potential to modify the course of depression, but the consistency and magnitude of this effect are currently undetermined.
METHODS
PRISMA and RIGHT compliant (PROSPERO:CRD42020179659) systematic meta-review, PubMed/Web of Science, up to June 2020. Meta-analyses of controlled interventions for the primary prevention of depressive symptoms [effect measures: standardized mean difference (SMD)] or depressive disorders [effect measure: relative risk (RR)] were carried out. Results were stratified by: (i) age range; (ii) target population (general and/or at-risk); (iii) intervention type. Quality (assessed with AMSTAR/AMSTAR-PLUS content) and credibility (graded as high/moderate/low) were assessed. USPSTF grading system was used for recommendations.
RESULTS
Forty-six meta-analyses (k=928 individual studies, n=286,429 individuals, mean age=22.4 years, 81.1% female) were included. Effect sizes were: SMD=0.08-0.53; for depressive symptoms; RR=0.90-0.28 for depressive disorders. Sensitivity analyses including only RCTs did not impact the findings. AMSTAR median=9 (IQR=8-9); AMSTAR-PLUS content median=4.25 (IQR=4-5). Credibility of the evidence was insufficient/low in 43 (93.5%) meta-analyses, moderate in two (4.3%), and high in one (2.2%): reduction of depressive symptoms using psychosocial interventions for young adults only, and a combination of psychological and educational interventions in primary care had moderate credibility; preventive administration of selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in individuals with a stroke had high credibility.
LIMITATIONS
Intervention heterogeneity and lack of long-term efficacy evaluation.
CONCLUSIONS
Primary preventive interventions for depression might be effective. Among them, clinicians may offer SSRIs post-stroke to prevent depressive disorders, and psychosocial interventions for children/adolescents/young adults with risk factors or during the prenatal/perinatal period.

Identifiants

DOI: 10.1016/j.jad.2021.07.101 PMID: 34375224
pubmed: 34375224
pii: S0165-0327(21)00780-1
doi: 10.1016/j.jad.2021.07.101
pii:
doi:

Substances chimiques

Serotonin Uptake Inhibitors 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

957-970

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Auteurs

Gonzalo Salazar de Pablo (G)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Marco Solmi (M)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, University of Ottawa; Department of Mental Health, The Ottawa Hospital.

Julio Vaquerizo-Serrano (J)

Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Joaquim Radua (J)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden.

Anastassia Passina (A)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Pierluca Mosillo (P)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Christoph U Correll (CU)

The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA; Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.

Stefan Borgwardt (S)

Department of Psychiatry, University of Basel, Switzerland; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.

Silvana Galderisi (S)

Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy.

Andreas Bechdolf (A)

Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Vivantes Klinikum im Friedrichshain, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.

Andrea Pfennig (A)

Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.

Michael Bauer (M)

Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.

Lars Vedel Kessing (LV)

Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Therese van Amelsvoort (T)

Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands.

Dorien H Nieman (DH)

Amsterdam University Medical Centers (location AMC), Department of Psychiatry, Amsterdam, Netherlands.

Katharina Domschke (K)

Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation (NeuroModul), Medical Faculty, University of Freiburg, Germany.

Marie-Odile Krebs (MO)

INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université de Paris, CNRS, GDR3557-Institut de Psychiatrie Paris, France; Faculté de Médecine Paris Descartes, GHU Paris - Sainte-Anne, Pole PEPIT Paris, France.

Michael Sand (M)

Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut.

Eduard Vieta (E)

Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.

Philip McGuire (P)

Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.

Celso Arango (C)

Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.

Jae Il Shin (JI)

Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.

Paolo Fusar-Poli (P)

Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address: paolo.fusar-poli@kcl.ac.uk.

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Classifications MeSH

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