Where to go from here? An exploratory meta-analysis of the most promising approaches to depression prevention programs for children and adolescents.
OBJECTIVE
To examine the overall effect of individual depression prevention programs on future likelihood of depressive disorder and reduction in depressive symptoms. In addition, we have investigated whether Cognitive Behavioural Therapy (CBT), Interpersonal Therapy (IPT) and other therapeutic techniques may modify this effectiveness.


METHODS
This study is based on and includes the trial data from meta-analyses conducted in the Cochrane systematic review of depression prevention programs for children and adolescents by Merry et al. (2011). All trials were published or unpublished English language randomized controlled trials (RCTs) or cluster RCTs of any psychological or educational intervention compared to no intervention to prevent depression in children and adolescents aged 5-19 years.


RESULTS
There is some evidence that the therapeutic approach used in prevention programs modifies the overall effect. CBT is the most studied type of intervention for depression prevention, and there is some evidence of its effectiveness in reducing the risk of developing a depressive disorder, particularly in targeted populations. Fewer studies employed IPT, however this approach appears promising. To our knowledge, this is the first study to have explored how differences in the approach taken in the prevention programs modify the overall treatment effects of prevention programs for children and adolescents.


CONCLUSIONS
More research is needed to identify the specific components of CBT that are most effective or indeed if there are other approaches that are more effective in reducing the risk of future depressive episodes. It is imperative that prevention programs are suitable for large scale roll-out, and that emerging popular modes of delivery, such as online dissemination continue to be rigorously tested.
Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, 3052, Australia. shetrick@unimelb.edu.au.
Sarah E
SE
Hetrick
Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, 3052, Australia. gcox@unimelb.edu.au.
Georgina R
GR
Cox
The Werry Centre for Child and Adolescent Mental Health, Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. s.merry@auckland.ac.nz.
Sally N
SN
Merry
D000293:Adolescent; D000067697:Adolescent Health; D001521:Behavior Therapy / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D055815:Young Adult