Healthcare interventions for depression in low socioeconomic status populations: A systematic review and meta-analysis.
Rojas-García A., Ruiz-Perez I., Rodríguez-Barranco M., Gonçalves Bradley DC., Pastor-Moreno G., Ricci-Cabello I.
The prevalence and impact of depressive disorders in developed countries are associated with certain population characteristics, including socioeconomic status. The aim of this systematic review and meta-analysis was to identify, characterize and analyze the short- and long-term effectiveness of healthcare interventions for depressive disorders in low socioeconomic status populations. The main biomedical databases were searched and fifteen articles assessing seventeen interventions were included in the review. Most interventions were implemented in the US (n=11) and culturally adapted (n=11). We conducted two meta-analyses for assessing both the short- (n=11) and long-term effectiveness (n=12) of interventions. There was a statistically significant reduction in overall depressive symptoms (-0.58, 95% CI [-0.74, -0.41]) at short-term (up to three months after the intervention), especially for combined and psychotherapeutic interventions. The overall effect slightly decreased at long-term (-0.42, 95% CI [-0.63, -0.21]). Those interventions including culturally specific training for providers and booster sessions seemed to be more effective in reducing depressive disorders at short and long term, respectively. In conclusion, healthcare interventions are effective in decreasing clinically significant depressive disorders in low socioeconomic status populations. Future interventions should take into account the key characteristics identified in this review.