Department of Psychiatry at San Francisco General Hospital, University of California, San Francisco, California 94110, USA.
Annu Rev Clin Psychol. 2010;6:181-212. doi: 10.1146/annurev-clinpsy-033109-132040.
Before the 1980s, no randomized controlled trials had been carried out to test whether major depressive episodes could be prevented. In the past 30 years, several trials have reported success in reducing the incidence (the number of new cases) of major depressive episodes. These studies suggest that major depression can be prevented. Given the large burden of disease caused by major depression, it is time for substantial systematic efforts to replicate these studies, carry out multisite trials, and widely disseminate prevention interventions found to be effective. The present review examines the conceptual and practical differences between treatment and prevention trials and the importance of identifying groups at high short-term risk for major depressive episodes to make prevention trials feasible. We also list the randomized controlled prevention trials that have been carried out to date and discuss the need for prevention interventions that go beyond the limits of traditional face-to-face interventions.
在 20 世纪 80 年代之前，没有进行过随机对照试验来检验是否可以预防重度抑郁发作。在过去的 30 年中，有几项试验报告称成功降低了重度抑郁发作的发病率（新发病例数）。这些研究表明，重度抑郁可以预防。鉴于重度抑郁造成的巨大疾病负担，现在是时候进行大量系统的努力来复制这些研究，开展多地点试验，并广泛推广已被证明有效的预防干预措施了。本综述探讨了治疗试验和预防试验之间的概念和实际差异，以及确定短期发生重度抑郁发作风险高的人群以实现预防试验可行性的重要性。我们还列出了迄今为止进行的随机对照预防试验，并讨论了需要超越传统面对面干预范围的预防干预措施的必要性。
