TY - JOUR
KW - Depressive Disorder, Major/epidemiology/prevention & control
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Primary Health Care/methods
KW - Risk Assessment/methods
KW - Spain/epidemiology
AU - J. A. Bellon
AU - S. Conejo-Ceron
AU - P. Moreno-Peral
AU - M. King
AU - I. Nazareth
AU - C. Martin-Perez
AU - C. Fernandez-Alonso
AU - A. Rodriguez-Bayon
AU - A. Fernandez
AU - J. M. Aiarzaguena
AU - C. Monton-Franco
AU - I. Ibanez-Casas
AU - E. Rodriguez-Sanchez
AU - M. I. Ballesta-Rodriguez
AU - A. Serrano-Blanco
AU - M. C. Gomez
AU - P. LaFuente
AU - Munoz-Garcia Mdel
AU - P. Minguez-Gonzalo
AU - L. Araujo
AU - D. Palao
AU - P. Bully
AU - F. Zubiaga
AU - D. Navas-Campana
AU - J. Mendive
AU - J. M. Aranda-Regules
AU - A. Rodriguez-Morejon
AU - L. Salvador-Carulla
AU - de Dios Luna
A1 - 
AB - 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.
BT - Annals of Internal Medicine
C5 - General Literature
CP - 10
CY - United States
DO - 10.7326/M14-2653
IS - 10
JF - Annals of Internal Medicine
N2 - 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.
PP - United States
PY - 2016
SN - 1539-3704; 0003-4819
SP - 656
EP - 665
EP - 
T1 - Intervention to Prevent Major Depression in Primary Care: A Cluster Randomized Trial
T2 - Annals of Internal Medicine
TI - Intervention to Prevent Major Depression in Primary Care: A Cluster Randomized Trial
U1 - General Literature
U2 - 27019334
U3 - 10.7326/M14-2653
VL - 164
VO - 1539-3704; 0003-4819
Y1 - 2016
ER -