title: Effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression: A systematic review of systematic reviews and meta-analyses.
abstract: OBJECTIVE
  To determine the effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression.
  
  
  METHODS
  Systematic review of systematic reviews and meta-analyses (SR/MA). We searched PubMed, PsycINFO, Cochrane Database of Systematic Reviews, OpenGrey, and PROSPERO from their inception until February 2014. Two reviewers independently evaluated the eligibility criteria of all SR/MA, abstracted data, and determined bias risk (AMSTAR).
  
  
  RESULTS
  Twelve SR/MA (156 non-repeated trials and 56,158 participants) were included. Of these, 142 (91%) were randomized-controlled, 13 (8.3%) controlled trials, and 1 (0.6%) had no control group. Five SR/MA focused on children and adolescents, four on specific populations (women after childbirth, of low socioeconomic status, or unfavorable circumstances; patients with severe traumatic physical injuries or stroke) and three addressed the general population. Nine (75%) SR/MA concluded that interventions to prevent depression were effective. Of the 156 trials, 137 (87.8%) reported some kind of effect size calculation. Effect sizes were small in 45 (32.8%), medium in 26 (19.1%), and large in 25 (18.2%) trials; 41 (29.9%) trials were not effective. Of the 141 trials for which follow-up periods were available, only 34 (24.1%) exceeded 12 months.
  
  
  CONCLUSIONS
  Psychological and/or educational interventions to prevent onset of episodes of depression were effective, although most had small or medium effect sizes.
authors.affiliation: Centro de Salud El Palo, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria Málaga-Guadalhorce, Departamento de Medicina Preventiva y Salud Pública, Universidad de Málaga, Málaga, Spain. Electronic address: jabellon@uma.es.
authors.forename: Juan Ángel
authors.initials: JÁ
authors.lastname: Bellón
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria Málaga-Guadalhorce, Málaga, Spain. Electronic address: predictmalaga@hotmail.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Moreno-Peral
authors.affiliation: Departamento de Psicología Psicología y Trabajo Social, Universidad de Loyola, Sevilla, Spain. Electronic address: emotrico@uloyola.es.
authors.forename: Emma
authors.initials: E
authors.lastname: Motrico
authors.affiliation: Departamento de Personalidad, Evaluación Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain. Electronic address: aromore@uma.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rodríguez-Morejón
authors.affiliation: Centre for Disability Research Policy - Brain Mind Research Institute, Faculty of Health Sciences, University of Sydney, Sydney, Australia; Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain. Electronic address: ana.fernandez@sydney.edu.au.
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández
authors.affiliation: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain. Electronic address: aserrano@pssjd.org.
authors.forename: Antoni
authors.initials: A
authors.lastname: Serrano-Blanco
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain. Electronic address: ezabaleta@idiapjgol.org.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-del-Olmo
authors.affiliation: Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Investigación del Distrito de Atención Primaria Málaga-Guadalhorce, Málaga, Spain. Electronic address: soniafundacionimabis@hotmail.com.
authors.forename: Sonia
authors.initials: S
authors.lastname: Conejo-Cerón
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003863:Depression / Q000517:prevention & control; D003866:Depressive Disorder / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D011322:Primary Prevention / Q000193:education*; D011613:Psychotherapy / Q000379:methods*; D012196:Review Literature as Topic
keywords: Depression; Primary prevention; Systematic review