Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions

Am J Psychiatry. 2008 Oct;165(10):1272-80. doi: 10.1176/appi.ajp.2008.07091422. Epub 2008 Sep 2.


Objective: A growing number of studies have tested the efficacy of preventive interventions in reducing the incidence of depressive disorders. Until now, no meta-analysis has integrated the results of these studies.

Method: The authors conducted a meta-analysis. After a comprehensive literature search, 19 studies were identified that met inclusion criteria. The studies had to be randomized controlled studies in which the incidence of depressive disorders (based on diagnostic criteria) in an experimental group could be compared with that of a control group.

Results: The mean incidence rate ratio was 0.78, indicating a reduction of the incidence of depressive disorders by 22% in experimental compared with control groups. Heterogeneity was low to moderate (I(2)=33%). The number needed to treat to prevent one case of depressive disorder was 22. Moderator analyses revealed no systematic differences between target populations or types of prevention (universal, selective, or indicated). The data included indications that prevention based on interpersonal psychotherapy may be more effective than prevention based on cognitive-behavioral therapy.

Conclusions: Prevention of new cases of depressive disorders does seem to be possible. Prevention may become an important way, in addition to treatment, to reduce the enormous public health burden of depression in the coming years.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Cognitive Behavioral Therapy
  • Counseling
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / prevention & control*
  • Health Education
  • Humans
  • Incidence
  • Interview, Psychological
  • Personality Assessment
  • Problem Solving
  • Psychotherapy
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Social Support