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Cognitive behavioural therapy can help to prevent depression
Bellon JA, Morena-Peral P, Motrico E, et al. Effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression: A systematic review of systematic reviews and meta-analyses Prev Med. 2015;76:S22–S32.
Do psychological approaches (eg. cognitive behavioural therapy) and educational approaches help prevent depression?
Depression is a major issue in many countries and is projected to be the greatest contributor to burden of illness in high-income countries by 2030. It is more advantageous to prevent rather than treat depression and there have been hundreds of studies and dozens of systematic reviews published on the topic. This systematic review of systematic reviews was conducted to compare the findings.
How the review was done
The review included 5 systematic reviews and 7 meta-analyses published between 2006 and 2014, including 156 randomized controlled trials and over 56,000 participants. All included systematic reviews and meta-analyses were of good quality.
Key features of studies included in this review:
- None of the participants had a diagnosis of depression at the start of the study.
- Participants took part in cognitive behavioural therapy or other types of therapy, counselling, self-help or received education and support, most provided by mental health specialists.
- Researchers measured the number of people who were diagnosed with depression and/or depressive symptoms during the study period.
- Results were compared with people in control groups who either received the usual care, other types of support, or were on a wait list.
What the researchers found
Cognitive behavioural therapy and other psychological or educational approaches had a small to moderate impact on preventing depression. These results however, included people with depression symptoms. When the results were limited to studies that only included participants without depression symptoms, the benefits of therapy were even greater. The populations, settings, and types of approaches varied widely. Cognitive behavioural therapy was the most common approach. More research is needed to learn more about the cost-effectiveness of depression prevention programs, the best approaches and populations to prioritize.
Depression prevention programs – using cognitive behavioural therapy and other psychological and educational approaches – show promise as effective ways to prevent depression in adults.
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
Related Evidence Summaries
British Journal of Psychiatry (2015)
Cochrane Database of Systematic Reviews (2016)
Cochrane Database of Systematic Reviews (2015)
Related Web Resources
Informed Health Online
Depression is a common mood disorder that can make it hard to cope with everyday life. Causes and risk factors for depression include genes, difficult experiences and life circumstances, chronic anxiety disorders, biochemical changes, medical problems, and lack of light. Psychological therapies (e.g., cognitive behavioral therapy) and medication, alone or combination, are treatment options.
This patient decision aid helps adults diagnosed as being depressed decide on the type of medicine by comparing the benefits, risks and side effects of each antidepressant.
UpToDate - patient information
Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
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