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Long-term efficacy of indicated prevention of depression in non-professional caregivers: randomized controlled trial

Published online by Cambridge University Press:  21 October 2014

P. Otero ,
F. Smit ,
P. Cuijpers ,
A. Torres ,
V. Blanco  and
F. L. Vázquez
P. Otero*
Affiliation:
Department of Clinical Psychology and Psychobiology, Unit of Depressive Disorders, University of Santiago de Compostela, Santiago de Compostela, Spain
F. Smit
Affiliation:
Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands Department of Epidemiology and Biostatics and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
P. Cuijpers
Affiliation:
Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands Leuphana University Innovation Incubator, Division Health Trainings Online, Lüneburg, Germany
A. Torres
Affiliation:
Department of Psychiatry, Radiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
V. Blanco
Affiliation:
Department of Clinical Psychology and Psychobiology, Unit of Depressive Disorders, University of Santiago de Compostela, Santiago de Compostela, Spain
F. L. Vázquez
Affiliation:
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
*
* Address for correspondence: P. Otero, Department of Clinical Psychology and Psychobiology, Unit of Depressive Disorders, University of Santiago de Compostela, Campus Vida, 15782, Santiago de Compostela, Spain. (Email: [email protected])
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Abstract

Background

Although depression is a common problem among non-professional caregivers, only one trial has evaluated the efficacy of indicated prevention targeting this population and the long-term efficacy is unknown. The aim of this study was to evaluate the long-term efficacy of a brief intervention for the indicated prevention of depression in a sample of female caregivers.

Method

A randomized controlled trial was conducted involving 173 participants (mean age 53.9 years) who were allocated to the intervention (n = 89) or the usual-care control group (n = 84). Blinded interviewers conducted assessments at 1, 3, 6 and 12 months of follow-up. The main outcome measure was the incidence of major depression and the secondary outcomes were compliance with treatment, depressive symptoms, emotional distress and caregiver burden.

Results

At the 12-month follow-up, a lower incidence of depression as evaluated using the Structured Clinical Interview for Axis I Disorders of the DSM-IV was found in the intervention group compared with the control group (10.1% v. 25.0%). The relative risk was 0.40 and statistically significant [χ2 = 6.68, degrees of freedom = 1, p = 0.010, 95% confidence interval (CI) 0.20–0.81], and the number needed to treat was 7 (95% CI 4–27). There was a significant delay in the onset of depression in the intervention group (p = 0.008). The good complier caregivers had a lower incidence of depression. The intervention effect on depressive symptoms, emotional distress and caregiver burden were maintained for 12 months.

Conclusions

This is the first study to demonstrate that a brief problem-solving intervention can prevent the onset of depression among non-professional caregivers over the longer term.

Keywords

Depressionindicated preventionlong-term efficacynon-professional caregiversproblem solving
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 7 , May 2015 , pp. 1401 - 1412
Copyright
Copyright © Cambridge University Press 2014 

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