Comparative efficacy of task-sharing psychosocial interventions for preventing common mental disorders in low- and middle-income countries: A systematic review and network meta-analysis with 10,747 participants.
Marianna Purgato, Eleonora Prina, Camilla Cadorin et al.
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In 30 seconds
This systematic review and network meta-analysis assessed task-sharing psychosocial interventions to prevent common mental disorders among adults in low- and middle-income countries. It included 81 randomised controlled trials with 10,747 participants, evaluating indicated, selective and universal prevention. Compared with enhanced treatment as usual or treatment as usual, several interventions reduced depression diagnoses (risk ratios 0.25 to 0.66) and depressive symptoms (standardized mean differences -0.94 to -0.36). Findings also supported symptom reduction for PTSD and benefits across anxiety outcomes, although evidence was stronger for indicated and selective prevention.
Key findings
- For depression prevention, wellbeing promotion, parental psychoeducation, yoga/mindfulness and multicomponent interventions had risk ratios of 0.25 to 0.66 versus enhanced treatment as usual or treatment as usual.
- Parental psychoeducation, social support, wellbeing promotion, yoga/mindfulness, cognitive behavioral therapy and multicomponent interventions reduced depressive symptoms (standardized mean differences -0.94 to -0.36 versus comparators).
- Yoga/mindfulness, parental psychoeducation, cognitive behavioral therapy and multicomponent interventions reduced PTSD symptoms.
- Wellbeing promotion and psychoeducation ranked highest in head-to-head depression-prevention comparisons (SUCRA>90%).
Why it matters
The findings suggest that psychosocial prevention delivered through task-sharing may help reduce mental disorder diagnoses or symptoms in LMIC settings, where prevention remains an evidence gap. The range of interventions associated with benefit offers a basis for considering prevention approaches suited to local contexts, while the stronger evidence for indicated and selective prevention highlights that support is not equally established across prevention levels.
What to keep in mind
Evidence was stronger for indicated and selective prevention than for universal prevention; only 7 RCTs tested universal interventions.