Summary of findings 1. Psychological interventions compared to treatment as usual in the prevention of the incidence of depression in adults with long‐term physical conditions.
| Psychological interventions compared to treatment as usual in the prevention of the incidence of depression in adults with long‐term physical conditions | ||||||
| Patient or population: adults with long‐term physical conditions (18 years or older) Setting: hospital Intervention: preventive psychological interventions Comparison: treatment as usual | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with treatment as usual | Risk with preventive psychological interventions | |||||
| Incidence of depression ‐ post‐intervention: 0 months follow‐up assessed with: diagnosis by DSM‐IV | Study population | OR 0.43 (0.20 to 0.95) | 194 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 2 3 4 | ||
| 23 per 100 | 12 per 100 (6 to 22) | |||||
| Incidence of depression ‐ short term: < 6 months follow‐up assessed with: diagnosis by DSM‐IV | Study population | OR 0.71 (0.36 to 1.38) | 190 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 2 3 4 | ||
| 27 per 100 | 21 per 100 (12 to 34) | |||||
| Incidence of depression ‐ medium term: 6‐12 months follow‐up | no data available | ‐ | (0 RCTs) | ‐ | ||
| Incidence of depression ‐ long term: > 12 months follow‐up | no data available | ‐ | (0 RCTs) | ‐ | ||
| Tolerability ‐ total number of adverse events | no data available | ‐ | (0 RCTs) | ‐ | ||
| acceptability ‐ drop‐outs due to adverse events | no data available | ‐ | (0 RCTs) | ‐ | ||
| acceptability ‐ drop‐outs due to any cause: post‐intervention | Study population | OR 5.21 (1.11 to 24.40) | 206 (1 RCT) | ⊕⊕⊝⊝ LOW 2 4 | ||
| 20 per 1.000 | 95 per 1.000 (22 to 330) | |||||
| acceptability ‐ drop‐outs due to any cause: < 6 months | Study population | OR 1.67 (0.58 to 4.77) | 206 (1 RCT) | ⊕⊕⊝⊝ LOW 2 4 | ||
| 59 per 1.000 | 95 per 1.000 (35 to 232) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 The low and high risk values are the two extreme numbers of incidences in the control groups from studies included in the review.
2 Downgraded once due to indirectness. Due to the nature of this review, we included all types of chronic physical illnesses. With only one study addressing psychological interventions, there is some uncertainty with the applicability of the effect to all types of diseases.
3 Downgraded once due to imprecision. The evidence is based on only one study with 194 participants.
4 Publication bias strongly suspected.