Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
Psychol Med. 2020 Apr;50(6):1002-1009. doi: 10.1017/S0033291719000916. Epub 2019 Apr 24.
Studies of psychological interventions for the prevention of depression have found significant effects in the short-term, but the long-term efficacy has yet to be determined. This study evaluated the 8-year effect of a randomized controlled trial for indicated prevention of depression in female caregivers.
A total of 173 non-professional female caregivers with subclinical depressive symptoms not meeting criteria for a major depressive episode (MDE) were randomized to either a brief problem-solving intervention (n = 89) or usual-care control group (n = 84). Blinded evaluators conducted an assessment at the 8-year follow-up. The primary outcome was Depression Status, defined by diagnoses of MDE since the 1-year follow-up using the Structured Clinical Interview for the Disorders of the DSM-5. The secondary outcome was current Depressive Symptom Severity. Regression analyses were conducted to evaluate the effect of the intervention on the outcomes.
There were no significant differences in the Depression Status between the problem-solving (30.3%) and control groups (26.2%) (adjusted OR 1.25, 95% CI -0.58 to 2.69). Depressive Symptom Severity, however, was significantly lower in the problem-solving group compared to the control group at this follow-up, amounting to a small effect size of Cohen's d = 0.39 (adjusted B = -3.32, p = 0.018).
This is the first study to assess such a long-term follow-up of intervention of indicated prevention of depression. Results seem to indicate that the protective effect of the intervention became smaller over time during follow-up. Future research should replicate these results.
针对预防抑郁症的心理干预措施的研究发现，这些措施在短期具有显著效果，但长期效果尚不确定。本研究评估了一项针对女性护理人员进行有针对性预防抑郁症的随机对照试验的 8 年效果。
共有 173 名非专业女性护理人员出现亚临床抑郁症状，但不符合重性抑郁发作（MDE）标准，她们被随机分配到简短的问题解决干预组（n=89）或常规护理对照组（n=84）。盲法评估人员在 8 年随访时进行评估。主要结局是抑郁状况，根据自 1 年随访以来使用 DSM-5 障碍定式临床访谈的 MDE 诊断来定义。次要结局是当前抑郁症状严重程度。回归分析用于评估干预对结局的影响。
在问题解决组（30.3%）和对照组（26.2%）之间，抑郁状况没有显著差异（调整后的 OR 1.25，95%CI-0.58 至 2.69）。然而，在这个随访中，问题解决组的抑郁症状严重程度明显低于对照组，其效应量为 Cohen's d=0.39（调整后的 B=-3.32，p=0.018）。
这是第一项评估这种针对抑郁症有针对性预防的干预措施进行如此长的随访的研究。结果似乎表明，随着时间的推移，干预的保护效果在随访过程中变小。未来的研究应该复制这些结果。
