Gladstone Tracy R G, Beardslee William R
Wellesley Centers for Women, Wellesley College, Boston, Massachusetts, USA.
Can J Psychiatry. 2009 Apr;54(4):212-21. doi: 10.1177/070674370905400402.
To review the recent literature on the prevention of clinical diagnoses of depression in children and adolescents.
Several preventive intervention programs targeting depressive diagnoses in youth were reviewed. These programs based their prevention strategies on cognitive-behavioural and (or) interpersonal approaches, which have been found to be helpful in the treatment of depression. In addition, family-based prevention strategies were reviewed. Also, nonspecific risk factors for youth depression, including poverty and child maltreatment, were discussed as important considerations in prevention programs targeting youth depression.
In general, successful prevention programs targeting youth depression are based on evidence-based treatment programs for youth depression, structured and outlined in manuals, involve careful training of personnel implementing the protocols, and include assessment of fidelity to the intervention protocols. The programs were consistent with cognitive-behavioural and (or) interpersonal psychotherapy traditions. Overall, it appears that there is reason for hope regarding the role of interventions in preventing depressive disorders in youth.
Several new directions for future research on the prevention of depression in youth were outlined. Future research is needed to establish an empirical base for the prevention of depression in high-risk youth and should: focus on targeted and indicated prevention approaches, attend to moderators of intervention effects, include approaches that aim to enhance the family environment, attend to nonspecific risk factors for disorder, and focus on the dissemination phase of prevention research.
回顾近期关于预防儿童和青少年抑郁症临床诊断的文献。
对针对青少年抑郁诊断的若干预防干预项目进行了综述。这些项目的预防策略基于认知行为和(或)人际方法,这些方法已被证明对抑郁症治疗有帮助。此外,还综述了基于家庭的预防策略。同时,还讨论了青少年抑郁症的非特异性风险因素,包括贫困和儿童虐待,这些是针对青少年抑郁症的预防项目中的重要考虑因素。
总体而言,成功的针对青少年抑郁症的预防项目基于青少年抑郁症的循证治疗项目,在手册中有结构化和概述,涉及对实施方案的人员进行仔细培训,并包括对干预方案依从性的评估。这些项目与认知行为和(或)人际心理治疗传统一致。总体而言,干预在预防青少年抑郁症方面的作用似乎有理由让人抱有希望。
概述了未来青少年抑郁症预防研究的几个新方向。未来的研究需要为高危青少年抑郁症的预防建立实证基础,并且应该:关注有针对性的和指导性的预防方法,关注干预效果的调节因素,包括旨在改善家庭环境的方法,关注疾病的非特异性风险因素,并关注预防研究的传播阶段。