| Autor: |
Bellón, Juan Ángel, Conejo-Cerón, Sonia, Moreno-Peral, Patricia, King, Michael, Nazareth, Irwin, Martín-Pérez, Carlos, Fernández-Alonso, Carmen, Rodríguez-Bayón, Antonina, Fernández, Anna, Aiarzaguena, José María, Montón-Franco, Carmen, Ibanez-Casas, Inmaculada, Rodríguez-Sánchez, Emiliano, Ballesta-Rodríguez, María Isabel, Serrano-Blanco, Antoni, Gómez, María Cruz, LaFuente, Pilar, Muñoz-García, María del Mar, Mínguez-Gonzalo, Pilar, Araujo, Luz |
| Předmět: |
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| Zdroj: |
Annals of Internal Medicine; 5/17/2016, Vol. 164 Issue 10, p656-665, 10p |
| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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