Ut austin utalk pay trial#

People involved in public health initiatives, school personnel and mental health clinicians.ĭepressive disorder is common. The aim of this review was to assess the efficacy of evidence‐based psychological interventions designed to prevent the onset of a depressive disorder and to reduce any existing symptoms of depression.

Ut austin utalk pay trial#

Such a trial should consider scalability as well as the potential for the intervention to do harm.Įvidence‐based psychological interventions for preventing depression in children and adolescents Depressive disorder as the primary outcome should be measured over the longer term, as well as clinician‐rated depression. Given the relative lack of evidence for universal interventions compared with attention placebo controls and the poor results from well‐conducted effectiveness trials of universal interventions, in our opinion any future such trials should test a depression prevention programme in an indicated targeted population using a credible attention placebo comparison group. We conclude that there is still not enough evidence to support the implementation of depression prevention programmes.įuture research should focus on current gaps in our knowledge. Interventions delivered to targeted populations, particularly those selected on the basis of depression symptoms, had larger effect sizes, but these seldom used an attention placebo comparison and there are practical difficulties inherent in the implementation of targeted programmes. Prevention programmes delivered to universal populations showed a sobering lack of effect when compared with an attention placebo control. However, the evidence was of moderate to low quality using the GRADE framework and the results were heterogeneous. Estimates of numbers needed to treat to benefit (NNTB = 11) compare well with other public health interventions.

Overall the results show small positive benefits of depression prevention, for both the primary outcomes of self‐rated depressive symptoms post‐intervention and depression diagnosis up to 12 months (but not beyond). Among trials implemented in universal populations a number used an attention placebo comparison in which the intervention consistently showed no effect. Of note were the lack of attention placebo‐controlled trials in targeted populations (none for depression diagnosis and four for depression symptoms). For trials implemented in targeted populations there was a statistically significantly beneficial effect of intervention (depression diagnosis RD ‐0.04, 95% CI ‐0.07 to ‐0.01 depression symptoms SMD ‐0.32, 95% CI ‐0.42 to ‐0.23). For trials implemented in universal populations there was no effect for depression diagnosis (RD ‐0.01, 95% CI ‐0.03 to 0.01) and a small effect for depression symptoms (SMD ‐0.11, 95% CI ‐0.17 to ‐0.05). The evidence from this review is unclear with regard to whether the type of population modified the overall effects there was statistically significant moderation of the overall effect for depression symptoms (P value = 0.0002), but not for depressive disorder (P value = 0.08). We rated this evidence as low to moderate quality according to the GRADE criteria. This effect persisted to the short‐term assessment point (up to three months) (SMD ‐0.31, 95% CI ‐0.45 to ‐0.17 P value < 0.0001 16 studies 1558 participants) and medium‐term (4 to 12 months) assessment point (SMD ‐0.12, 95% CI ‐0.18 to ‐0.05 P value = 0.0002 53 studies 11,913 participants) however, the effect was no longer evident at the long‐term follow‐up. There were 70 trials (73 trial arms) with 13,829 participants that contributed to the analysis for the primary outcome of depression symptoms (self‐rated) at the post‐intervention time point, with results showing a small but statistically significant effect (standardised mean difference (SMD) ‐0.21, 95% CI ‐0.27 to ‐0.15 P value < 0.0001). We rated this evidence as moderate quality according to the GRADE criteria. Twenty‐nine trials were carried out in unselected populations and 53 in targeted populations.įor the primary outcome of depression diagnosis at medium‐term follow‐up (up to 12 months), there were 32 trials with 5965 participants and the risk of having a diagnosis of depression was reduced for participants receiving an intervention compared to those receiving no intervention (risk difference (RD) ‐0.03, 95% confidence interval (CI) ‐0.05 to ‐0.01 P value = 0.01). The majority of trials (67) were carried out in school settings with eight in colleges or universities, four in clinical settings, three in the community and four in mixed settings.