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

• Published in: Psychological medicine Vol. 45; no. 7; pp. 1401 - 1412
• Main Authors: Otero, P., Smit, F., Cuijpers, P., Torres, A., Blanco, V., Vázquez, F. L.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.05.2015
• Subjects: Adult; Aged; Caregivers; Caregivers - psychology; Clinical trials; Depressive Disorder, Major - prevention & control; Depressive Disorder, Major - therapy; Disease prevention; Female; Follow-Up Studies; Humans; Male; Mental depression; Middle Aged; Original Articles; Problem Solving; Psychotherapy - methods; Single-Blind Method; Time Factors; Treatment Outcome; long-term efficacy; Depression; problem solving; indicated prevention; non-professional caregivers
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291714002505

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. 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. 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. 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.