Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.

Sebastien Brodeur; Dominic Oliver; Muhammad Ahmed; Joaquim Radua; Jemma Venables; Yueming Gao; Vincenzo  Gigante; Giulia  Veneziano; Giulia  Vinci; Edward Chesney; Sunil Nandha; Andrea De Micheli; Ilaria Basadonne; Valentina Floris; Gonzalo Salazar de Pablo; Paolo Fusar-Poli

Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.

Sebastien Brodeur, Dominic Oliver^*, Muhammad Ahmed, Joaquim Radua, Jemma Venables, Yueming Gao, Vincenzo Gigante, Giulia Veneziano, Giulia Vinci, Edward Chesney, Sunil Nandha, Andrea De Micheli, Ilaria Basadonne, Valentina Floris, Gonzalo Salazar de Pablo, Paolo Fusar-Poli

^*Corresponding author for this work

Early Psychosis: Interventions and Clinical -Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
Département de Psychiatrie et Neurosciences, Université Laval, Canada
Department of Psychiatry, University of Oxford, Oxford
NIHR Oxford Biomedical Research Centre (BRC)
OPEN early detection service, Oxford Health NHS Foundation Trust, Oxford
SLaM South London and Maudsley NHS Foundation Trust
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
IDIBAPS, CIBERSAM, Instituto de Salud Carlos III
Early Psychosis: Intervention and Clinical-prediction (EPIC) Lab, Department of Psychosis Studies, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
Department of Psychiatry, University of Cambridge, Downing Street, Cambridge, CB2 3EB
Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. [email protected].
Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London, SE5 8AF, UK.
Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, London, United Kingdom
Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab Department of Psychosis Studies Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, UK
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany; Max Planck School of Cognition, Leipzig, Germany.

Research output: Contribution to journal › Review article › peer-review

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.

Original language	English
Journal	Neuroscience and Biobehavioral Reviews
Publication status	Accepted/In press - 7 Apr 2024

Cite this

Brodeur, S., Oliver, D., Ahmed, M., Radua, J., Venables, J., Gao, Y., Gigante, V., Veneziano, G., Vinci, G., Chesney, E., Nandha, S., De Micheli, A., Basadonne, I., Floris, V., Salazar de Pablo, G., & Fusar-Poli, P. (Accepted/In press). Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews.

@article{6599153348eb40c3937fb4c415089d3c,

title = "Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.",

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.",

author = "Sebastien Brodeur and Dominic Oliver and Muhammad Ahmed and Joaquim Radua and Jemma Venables and Yueming Gao and Vincenzo Gigante and Giulia Veneziano and Giulia Vinci and Edward Chesney and Sunil Nandha and {De Micheli}, Andrea and Ilaria Basadonne and Valentina Floris and {Salazar de Pablo}, Gonzalo and Paolo Fusar-Poli",

year = "2024",

month = apr,

day = "7",

language = "English",

journal = "Neuroscience and Biobehavioral Reviews",

issn = "0149-7634",

}

Brodeur, S, Oliver, D, Ahmed, M, Radua, J, Venables, J, Gao, Y, Gigante, V, Veneziano, G, Vinci, G, Chesney, E, Nandha, S, De Micheli, A, Basadonne, I, Floris, V, Salazar de Pablo, G & Fusar-Poli, P 2024, 'Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.', Neuroscience and Biobehavioral Reviews.

TY - JOUR

T1 - Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.

AU - Brodeur, Sebastien

AU - Oliver, Dominic

AU - Ahmed, Muhammad

AU - Radua, Joaquim

AU - Venables, Jemma

AU - Gao, Yueming

AU - Gigante, Vincenzo

AU - Veneziano, Giulia

AU - Vinci, Giulia

AU - Chesney, Edward

AU - Nandha, Sunil

AU - De Micheli, Andrea

AU - Basadonne, Ilaria

AU - Floris, Valentina

AU - Salazar de Pablo, Gonzalo

AU - Fusar-Poli, Paolo

PY - 2024/4/7

Y1 - 2024/4/7

N2 - 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.

AB - 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.

M3 - Review article

SN - 0149-7634

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

ER -

Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: systematic review and meta-analysis.

Abstract

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