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Problem-solving intervention to prevent depression in non-professional caregivers: a randomized controlled trial with 8 years of follow-up

Published online by Cambridge University Press:  24 April 2019

Lara López ,
Filip Smit ,
Pim Cuijpers ,
Patricia Otero ,
Vanessa Blanco ,
Ángela Torres  and
Fernando L. Vázquez
Lara López*
Affiliation:
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
Filip Smit
Affiliation:
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam Medical Centers, Amsterdam, The Netherlands
Pim Cuijpers
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Patricia Otero
Affiliation:
Department of Psychology, University of A Coruña, A Coruña, Spain
Vanessa Blanco
Affiliation:
Department of Evolutive and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
Ángela Torres
Affiliation:
Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
Fernando L. Vázquez
Affiliation:
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
*
Author for correspondence: Lara López, E-mail: l.ares@usc.es
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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Caregivercognitive-behavioural therapydepressionpreventionproblem-solvingrandomized controlled trial
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 6 , April 2020 , pp. 1002 - 1009
Copyright
Copyright © Cambridge University Press 2019

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