The following is a summary of “Psychological interventions to prevent the onset of major depression in adults: a systematic review and individual participant data meta-analysis,” published in the December 2024 issue of Psychiatry by Buntrock et al. 

Psychological interventions may prevent major depressive disorder (MDD) in adults with subthreshold symptoms, but their effectiveness needs review. 

Researchers conducted a retrospective study to assess the impact of preventive interventions on MDD onset in adults with subthreshold symptoms.  

They screened eligible studies from the Metapsy domain (in English, German, Spanish, and Dutch) up to May 1, 2023. Data from randomized trials comparing psychological interventions with controls in adults with subthreshold symptoms but no baseline MDD was included. The risk of bias was assessed using RoB 2. MDD onset and moderators were analyzed through 1-stage meta-analysis, with survival analyses for time to onset within 12 months.  

The results showed that 30 of 42 trials with 7,201 participants (30.9% male, 68.9% female, 0.2% not reporting sex) were analyzed (3,697 intervention, 3504 control). The mean age was 49.9 years (SD 19.2). Of 3152 reporting ethnicities, 51.0% were White. Psychological interventions reduced MDD incidence post-treatment (IRR 0.57 [95% CI 0.35–0.93]; τ2=0.29; 18 studies) within 6 months (0.58 [0.39–0.88]; τ2=0.11; 18 studies), and within 12 months (0.67 [0.51–0.88]; τ2=0.05; 19 studies), but not at 24 months (IRR 1.16 [0.66–2.03]; τ2=0.10; 6 studies). Preventive effects were stronger for participants without prior psychotherapy (IRR 0.39 [0.25–0.62]) vs those with prior psychotherapy (0.92 [0.61–1.36]; P=0.029; 7 studies). Higher baseline depression and anxiety scores predicted greater MDD reductions. Conference calls outperformed other delivery formats (P=0.002), based on 2 studies. Age showed no significant effects. 

Investigators demonstrated the effectiveness of preventive psychological interventions for subthreshold depressive symptoms. Tailored approaches considering individual and study factors enhanced their population-level impact. 

Source: thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00316-X/fulltext