Psychosocial preventive interventions to reduce depressive symptoms in low-SES women at risk: A meta-analysis

Background: Women who have low socioeconomic status (SES) or live in disadvantaged circumstances are a vulnerable group at risk for depression. Little is known about the efficacy of preventive interventions to reduce depressive symptoms in low-SES women. The aim of this study is to provide an overview of controlled outcome studies and to investigate the overall efficacy and moderators of interventions targeted at reducing depressive symptoms in this population. Methods: A systematic review and meta-analysis were conducted for 14 studies (N = 1396). The effect size of the studies was computed for outcomes assessing changes in depressive symptom levels using the standardized mean difference effect size. Study, target population, and intervention descriptors expected to influence effect size were analyzed using univariate subgroup and metaregression techniques with mixed-effects statistical models. Results: The estimated overall effect size of 0.31 was significant; study sample characteristics, intervention characteristics and the research design of the studies did not moderate intervention effects. Limitations: Limitations to this study are the relatively limited number of well controlled studies that could be included in the analyses. Conclusions: A number of promising programs have been developed specifically for low-SES women, a population at high risk for developing major depression. On average these programs were found to reduce the level of depressive symptoms, with more than half of the studies showing medium to large effect sizes. This indicates that considerable mental health benefits can be gained among disadvantaged women. (C) 2010 Elsevier B.V. All rights reserved.