A personalized depression intervention prevents anxiety: Secondary study of a cluster randomized trial

Abstract

Abstract Background: In the predictD-intervention, general practitioners (GPs) used a personalized bio-psycho-social program to prevent depression. This reduced the incidence of major depression by 21% although it was not statistically significant. Aim: Was the predictD-intervention effective in preventing anxiety in non-depressive and non-anxious primary care patients? Design and Setting: Secondary study of a cluster randomized trial with practices randomly assigned to either the predictD-intervention or CAU. This study was conducted in seven Spanish cities from October 2010 to July 2012. Methods: In each city, we randomly selected 10 practices and 2 GPs per practice as well as 4-6 patients every recruiting day until there were 26-27 eligible patients for each GP. The endpoint was cumulative incidence of anxiety as measured by the PRIME-MD over 18 months. Results: A total of 3326 non-depressed patients and 140 GPs from 70 practices consented and were eligible to participate, and 328 were removed because they had an anxiety syndrome at baseline. Of the 2998 valid patients, 2597 (86.6%) were evaluated at the end of the study. At 18 months, 10.43% (95%C.I.: 8.73% to 12.13%) of the patients in the predictD-intervention group developed anxiety compared with 13.1% (11.4% to 14.79%) in the CAU group (difference, -2.67% [-5.05% to -0.28%]; P=0.029). Conclusion: A personalized intervention delivered by GPs for the prevention of depression provided a modest but statistically significant reduction in the incidence of anxiety.