Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands.
Institute for International Internet Interventions for Health (i4Health), Palo Alto University, United States.
Clin Psychol Rev. 2021 Feb;83:101955. doi: 10.1016/j.cpr.2020.101955. Epub 2020 Dec 3.
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.
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.
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.
Prevention is a promising approach to reduce the global disease burden of depression in addition to treatments.
抑郁障碍较为常见，对患者和社会均有较大影响。目前已有多种治疗方法，但疗效有限，只能在一定程度上减轻负担。预防抑郁障碍的发生可能是进一步降低全球疾病负担的一种选择。
我们对无基线抑郁诊断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心理干预组、常规护理组或可比对照组，在随访中通过诊断性访谈确定抑郁的新发病例。
我们系统的检索共得到了 50 项试验（14665 名参与者），这些试验的质量相对较高，涉及各个年龄段的高风险人群。心理干预大多基于认知行为干预。预防干预一年后，抑郁障碍的相对风险为 RR=0.81（95%CI：0.72-0.91），这表明接受干预的人发生抑郁障碍的几率降低了 19%。考虑到对照组的平均控制事件发生率为 30%，与对照组相比，每 21 人接受干预就能预防 1 例抑郁障碍。
预防是除治疗以外降低全球抑郁疾病负担的一种很有前景的方法。
