title: Long-term Follow-up of a Randomized Clinical Trial Assessing the Efficacy of a Brief Cognitive-Behavioral Depression Prevention Intervention for Caregivers with Elevated Depressive Symptoms.
abstract: To evaluate the efficacy of a cognitive-behavioral intervention for the prevention of depression in caregivers with elevated depressive symptoms through 12 months of follow-up.
  
  
  
  Randomized controlled trial.
  
  
  
  Community in Galicia (Spain).
  
  
  
  170 caregivers with elevated depressive symptoms.
  
  
  
  Caregivers were randomized to a cognitive-behavioral intervention (N = 88), administered to groups of five participants in five weekly 90-min sessions, or to a usual care control group (N = 82).
  
  
  
  Major depressive episodes (according to the Structured Clinical Interview for Axis I Disorders of the DSM-IV), depressive symptoms, emotional distress, caregiver burden, pleasant activities, depressive thoughts, social contacts. Trained blinded interviewers conducted assessments at 1, 3, 6, and 12 months of follow-up.
  
  
  
  At the 12-month follow-up, there was a lower incidence of major depressive episodes in the intervention group compared with the control group (3.4% versus 22.0%). The relative risk was 0.15 (95% CI: 0.05-0.51) and the number needed to treat was 5 (95% CI: 3-11). The time of delay of the depressive episode onset in the intervention group was significant. Caregivers with good compliance to the intervention had a lower incidence of depression. The effects of the intervention on depressive symptoms, emotional distress, and caregiver burden were maintained for 12 months. Younger caregivers were more likely to benefit from the intervention. The change in depressive thoughts mediated the reduction in depressive symptoms.
  
  
  
  Depressive episodes can be successfully prevented in caregivers, with long-term effects.
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain. Electronic address: fernandolino.vazquez@usc.es.
authors.forename: Fernando L
authors.initials: FL
authors.lastname: Vázquez
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: Research Group on Mental Health and Psychopathology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Blanco
authors.affiliation: Research Group on Mental Health and Psychopathology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Otero
authors.affiliation: Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Díaz
authors.affiliation: Department of Social, Basic and Methodological Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Ferraces
mesh_terms: D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000517:prevention & control* / Q000628:therapy; D003865:Major Depressive Disorder / Q000517:prevention & control* / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
keywords: cognitive-behavioral intervention; depression; indicated prevention; long-term follow-up; non-professional caregiver