title: Differential response to depression prevention among a sample of informal caregivers: Moderator analysis of longer-term follow-up trial data.
abstract: Depression is one of the most common mental disorders in caregivers. Therefore, preventive interventions for this population are needed, especially for caregivers with subclinical symptoms of depression. However, no study to date has identified the characteristics of caregivers that help to predict who will or will not benefit from such a preventive intervention. This study aimed to identify moderators of response to intervention comparing problem solving and usual care in indicated prevention of depression among informal caregivers. A randomized controlled trial was conducted involving 173 participants who were allocated to the problem-solving intervention (n=89) or the usual-care control-group (n=84), with 12-months follow-up. Socio-demographic, care-related and clinical variables at baseline were analyzed as potential moderators of intervention response at 12-months follow-up. Age and emotional distress emerged as significant moderators. Those caregivers younger than 65 years and with higher emotional distress at baseline were more likely to benefit from the intervention than from usual care. Simultaneous consideration of multiple moderators found that intervention was indicated for 95.4% of the sample. Considering these moderators in clinical decision-making could contribute to matching treatments and health service users in a more personalized and effective way.
authors.affiliation: Unit of Depressive Disorders, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain. Electronic address: patricia.otero@usc.es.
authors.forename: Patricia
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; Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Filip
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: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: DeRubeis
authors.affiliation: Department of Psychiatry, Radiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Torres
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Fernando L
authors.initials: FL
authors.lastname: Vázquez
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D013315:Stress, Psychological / Q000523:psychology*
keywords: Caregiver; Depression; Moderator; Prevention; Problem-solving