Abstract：
The effectiveness of universal preventive approaches in reducing the incidence of affective/psychotic disorders is unclear. We therefore aimed to synthesise the available evidence from randomised controlled trials. For studies reporting change in prevalence, we simulated all possible scenarios for the proportion of individuals with the disorder at baseline and at follow-up to exclude them. We then combined these data with studies directly measuring incidence and conducted random effects meta-analysis with relative risk (RR) to estimate the incidence in the intervention group compared to the control group. Eighteen studies (k=21 samples) were included investigating the universal prevention of depression in 66,625 individuals. No studies were available investigating universal prevention on the incidence of bipolar/psychotic disorders. 63 % of simulated scenarios showed a significant preventive effect on reducing the incidence of depression (k=9 - 19, RR=0.75-0.94, 95 %CIs=0.55-0.87,0.93-1.15, p=0.007-0.246) but did not survive sensitivity analyses. There is some limited evidence for the effectiveness of universal interventions for reducing the incidence of depression but not for bipolar/psychotic disorders.
摘要：
普遍的预防方法在减少情感/精神障碍发生率方面的有效性尚不清楚。因此，我们旨在从随机对照试验中综合现有证据。对于报告患病率变化的研究，我们模拟了基线时和随访时患有该疾病的个体比例的所有可能情况,以排除它们.然后，我们将这些数据与直接测量发病率的研究相结合，并进行了具有相对风险（RR）的随机效应荟萃分析，以估计干预组与对照组相比的发病率。包括18项研究（k=21个样本），调查了66,625名个体对抑郁症的普遍预防。没有研究调查双相情感障碍/精神病发病率的普遍预防。63%的模拟情景对降低抑郁症的发生率有显著的预防作用(k=9-19,RR=0.75-0.94,95CIs=0.55-0.87,0.93-1.15,p=0.007-0.246),但没有存活敏感性分析。有一些有限的证据表明，普遍干预措施对降低抑郁症发病率的有效性，但对双相情感障碍/精神障碍没有影响。
