• Revista médica de Chile · Oct 2021

    Meta Analysis

    [Systematic review of treatment alternatives for depressed adults with early adverse stress].

    • Pablo Martínez, Sergio Gloger, Dante Diez de Medina, Arantza González, María I Carrasco, and Paul A Vöhringer.
    • Clinical & Research Group, Santiago, Chile.
    • Rev Med Chil. 2021 Oct 1; 149 (10): 1473-1484.

    BackgroundEarly adverse stress is a risk factor for the appearance of mental health ailments during adulthood.AimTo systematically review treatment outcomes on mental health symptoms and functional domains, and of interventions aimed at treating adults with depressive disorders and early adverse stress (EAS).Material And MethodsSystematic review and meta-analysis including experimental and quasi-experimental published studies indexed in the CINAHL, EMBASE, PubMed, and Web of Science databases, which explored the effectiveness of treatment interventions for depressive disorders in adults exposed to EAS. Data on outcomes was extracted from the included studies. A narrative, qualitative approach or a quality-effects model for meta-analysis were used for synthesizing these data.ResultsThirteen studies were included. Psychological or combined treatment interventions for depression in adults exposed to EAS may be effective in reducing trauma-related symptoms and social dysfunction in the short-and mid-term, with small effect size and without substantive heterogeneity. The assessment of anxiety symptoms and health-related quality of life yielded mixed results.ConclusionsDespite the ubiquity of EAS and its adverse and long-lasting consequences for well-being and health, treatment alternatives are scant. This review suggests that there are treatment interventions for depression in adults exposed to EAS that may achieve integral mental health benefits, alleviating its impact on various symptoms and functional domains, when EAS is explicitly considered in the treatment intervention.

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