Intervention to Prevent Major Depression in Primary Care: A Cluster Randomized Trial.
Ann Intern Med
; 164(10): 656-65, 2016 May 17.
Article
en En
| MEDLINE
| ID: mdl-27019334
ABSTRACT
BACKGROUND:
Not enough is known about universal prevention of depression in adults.OBJECTIVE:
To evaluate the effectiveness of an intervention to prevent major depression.DESIGN:
Multicenter, cluster randomized trial with sites randomly assigned to usual care or an intervention. (ClinicalTrials.gov NCT01151982).SETTING:
10 primary care centers in each of 7 cities in Spain.PARTICIPANTS:
Two primary care physicians (PCPs) and 5236 nondepressed adult patients were randomly sampled from each center; 3326 patients consented and were eligible to participate. INTERVENTION For each patient, PCPs communicated individual risk for depression and personal predictors of risk and developed a psychosocial program tailored to prevent depression. MEASUREMENTS New cases of major depression, assessed every 6 months for 18 months.RESULTS:
At 18 months, 7.39% of patients in the intervention group (95% CI, 5.85% to 8.95%) developed major depression compared with 9.40% in the control (usual care) group (CI, 7.89% to 10.92%) (absolute difference, -2.01 percentage points [CI, -4.18 to 0.16 percentage points]; P = 0.070). Depression incidence was lower in the intervention centers in 5 cities and similar between intervention and control centers in 2 cities.LIMITATION:
Potential self-selection bias due to nonconsenting patients.CONCLUSION:
Compared with usual care, an intervention based on personal predictors of risk for depression implemented by PCPs provided a modest but nonsignificant reduction in the incidence of major depression. Additional study of this approach may be warranted. PRIMARY FUNDING SOURCE Institute of Health Carlos III.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Trastorno Depresivo Mayor
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann Intern Med
Año:
2016
Tipo del documento:
Article