Prevention and early intervention for depression in young people--a practical possibility?
OBJECTIVE
Many studies aimed at prevention and early intervention for mental disorders have focused on depressive disorder because it causes substantial disability. In this review, recent developments in prevention and early intervention with children and adolescents who are depressed are summarized.


RESULTS
Despite early promise, there is little evidence that prevention of depression is a practical possibility at this stage. There is no clear evidence of effectiveness for universal programmes. Targeted programmes are more promising, with evidence of short-term reduction in depressive symptoms, and there are a few studies in which there is evidence of a reduced incidence of disorder. There are promising developments in efforts to screen for disorder, although there is a requirement for more effective therapy. Potential cost-savings are considerable, so it is imperative that the search continues for effective interventions for depression in young people. Attention to wider social issues that impact on mental health is also needed.


CONCLUSIONS
Developing preventive services for depression is premature at this stage. There is evidence to support screening for depression and providing early intervention, but current treatments have limited effectiveness. There is a compelling need for further research in this area.
Merry
Sally Nicola
SN
Werry Centre for Child and Adolescent Mental Health, Department of Psychological Medicine, FMHS, University of Auckland, Auckland, New Zealand. s.merry@auckland.ac.nz
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D005240:Feasibility Studies; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008605:Mental Health Services / Q000458:organization & administration; D011613:Psychotherapy; D012959:Socioeconomic Factors; D013997:Time Factors