Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace

Background

Depression is a major public health problem among working-age adults. The workplace is potentially
an important location for interventions aimed at preventing the development of depression, but to date, the
mental health impact of universal interventions in the workplace has been unclear.

Method

A systematic search was conducted in relevant databases to identify randomized controlled trials of
workplace interventions aimed at universal prevention of depression. The quality of studies was assessed using the
Downs and Black checklist. A meta-analysis was performed using results from studies of adequate methodological
quality, with pooled effect size estimates obtained from a random effects model.

Results

Nine workplace-based randomized controlled trials (RCT) were identified. The majority of the included
studies utilized cognitive behavioral therapy (CBT) techniques. The overall standardized mean difference (SMD)
between the intervention and control groups was 0.16 (95% confidence interval (CI): 0.07, 0.24, P = 0.0002),
indicating a small positive effect. A separate analysis using only CBT-based interventions yielded a significant SMD
of 0.12 (95% CI: 0.02, 0.22, P = 0.01).

Conclusions

There is good quality evidence that universally delivered workplace mental health interventions can
reduce the level of depression symptoms among workers. There is more evidence for the effectiveness of
CBT-based programs than other interventions. Evidence-based workplace interventions should be a key component
of efforts to prevent the development of depression among adults.

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