Departments of Psychiatry and Behavioral Sciences, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Prev Sci. 2018 Feb;19(Suppl 1):74-94. doi: 10.1007/s11121-016-0737-1.
This paper presents the first findings of an integrative data analysis of individual-level data from 19 adolescent depression prevention trials (n = 5210) involving nine distinct interventions across 2 years post-randomization. In separate papers, several interventions have been found to decrease the risk of depressive disorders or elevated depressive/internalizing symptoms among youth. One type of intervention specifically targets youth without a depressive disorder who are at risk due to elevated depressive symptoms and/or having a parent with a depressive disorder. A second type of intervention targets two broad domains: prevention of problem behaviors, which we define as drug use/abuse, sexual risk behaviors, conduct disorder, or other externalizing problems, and general mental health. Most of these latter interventions improve parenting or family factors. We examined the shared and unique effects of these interventions by level of baseline youth depressive symptoms, sociodemographic characteristics of the youth (age, sex, parent education, and family income), type of intervention, and mode of intervention delivery to the youth, parent(s), or both. We harmonized eight different measures of depression utilized across these trials and used growth models to evaluate intervention impact over 2 years. We found a significant overall effect of these interventions on reducing depressive symptoms over 2 years and a stronger impact among those interventions that targeted depression specifically rather than problem behaviors or general mental health, especially when baseline symptoms were high. Implications for improving population-level impact are discussed.
本文介绍了对 19 项青少年抑郁预防试验（n=5210）的个体水平数据进行综合数据分析的初步结果，这些试验涉及 9 种不同的干预措施，在随机分组后 2 年内进行。在几篇单独的论文中，已经发现几种干预措施可以降低青少年发生抑郁障碍或出现抑郁/内化症状的风险。一种干预措施专门针对没有抑郁障碍但因抑郁症状升高和/或有抑郁障碍父母的青少年。第二种干预措施针对两个广泛的领域：预防行为问题，我们将其定义为药物使用/滥用、性风险行为、品行障碍或其他外化问题以及一般心理健康。这些干预措施中的大多数都改善了育儿或家庭因素。我们通过青少年的基线抑郁症状水平、青少年的社会人口学特征（年龄、性别、父母教育程度和家庭收入）、干预类型以及向青少年、父母或两者同时提供干预措施的方式，来检查这些干预措施的共同和独特效果。我们协调了这些试验中使用的八种不同的抑郁测量方法，并使用增长模型评估了干预措施在 2 年内的影响。我们发现，这些干预措施对降低青少年在 2 年内的抑郁症状有显著的总体效果，而且针对抑郁而非行为问题或一般心理健康的干预措施效果更强，尤其是在基线症状较高的情况下。还讨论了提高人群水平影响的意义。
