title: Long-term efficacy of indicated prevention of depression in non-professional caregivers: randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Clinical Psychology and Psychobiology,Unit of Depressive Disorders, University of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: P
authors.initials: P
authors.lastname: Otero
authors.affiliation: Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University,Amsterdam,The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Smit
authors.affiliation: Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University,Amsterdam,The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Department of Psychiatry, Radiology and Public Health,University of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.affiliation: Department of Clinical Psychology and Psychobiology,Unit of Depressive Disorders, University of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: V
authors.initials: V
authors.lastname: Blanco
authors.affiliation: Department of Clinical Psychology and Psychobiology,University of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: F L
authors.initials: FL
authors.lastname: Vázquez
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003865:Major Depressive Disorder / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011613:Psychotherapy / Q000379:methods*; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
keywords: problem solving