Cuijpers Pim
Department of Clinical Psychology and EMGO Institute, VU University Amsterdam, The Netherlands.
Dialogues Clin Neurosci. 2009;11(4):447-54. doi: 10.31887/DCNS.2009.11.4/pcuijpers.
In the past 15 years a considerable number of studies have found evidence that it may be possible to prevent the onset of some mental disorders. Most evidence is available for depressive disorders, but a growing number of studies have focused on anxiety disorders and psychotic disorders. This paper reviews the studies which have examined the effects of preventive interventions on the incidence of mental disorders in people who do not meet criteria for a mental disorder at baseline. More than 20 studies have examined prevention of depressive disorders, and they have found an overall reduction in the incidence of about 25% compared with control groups. The problem of identifying the most optimal target groups for preventive interventions is also illustrated. This is a problem because most risk indicators have a low specificity, and most people with a risk indicator do not develop a mental disorder. Finally, this paper will show how other statistics, such as the exposure rate, the attributable fraction, and the number needed to treat can help in identifying the most optimal target groups for preventive interventions.
在过去15年里，大量研究发现有证据表明，预防某些精神障碍的发病或许是可行的。关于抑郁症的证据最为充分，但越来越多的研究聚焦于焦虑症和精神障碍。本文回顾了那些检验预防性干预措施对基线时不符合精神障碍标准的人群中精神障碍发病率影响的研究。20多项研究检验了抑郁症的预防情况，结果发现与对照组相比，发病率总体降低了约25%。文中还阐述了确定预防性干预措施的最佳目标群体这一问题。这是个难题，因为大多数风险指标的特异性较低，而且大多数有风险指标的人并未患上精神障碍。最后，本文将说明诸如暴露率、归因分数和需治疗人数等其他统计数据如何有助于确定预防性干预措施的最佳目标群体。
