Rasing Sanne P A, Creemers Daan H M, Janssens Jan M A M, Scholte Ron H J
Behavioural Science Institute, Radboud UniversityNijmegen, Netherlands.
GGZ Oost BrabantBoekel, Netherlands.
Front Psychol. 2017 Jun 28;8:1066. doi: 10.3389/fpsyg.2017.01066. eCollection 2017.
Depression and anxiety disorders are among the most common mental disorders during adolescence. During this life phase, the incidence of these clinical disorders rises dramatically, and even more adolescents suffer from symptoms of depression or anxiety that are just below the clinical threshold. Both clinical and subclinical levels of depression or anxiety symptoms are related to decreased functioning in various areas, such as social and academic functioning. Prevention of depression and anxiety in adolescents is therefore imperative. We conducted a meta-analytic review of the effects of school-based and community-based prevention programs that are based on cognitive behavioral therapy with the primary goal preventing depression, anxiety, or both in high risk adolescents. Articles were obtained by searching databases and hand searching reference lists of relevant articles and reviews. The selection process yielded 32 articles in the meta-analyses. One article reported on two studies and three articles reported on both depression and anxiety. This resulted in a total of 36 studies, 23 on depression and 13 on anxiety. For depression prevention aimed at high risk adolescents, meta-analysis showed a small effect of prevention programs directly after the intervention, but no effect at 3-6 months and at 12 months follow-up. For anxiety prevention aimed at high risk adolescents, no short-term effect was found, nor at 12 months follow-up. Three to six months after the preventive intervention, symptoms of anxiety were significantly decreased. Although effects on depression and anxiety symptoms were small and temporary, current findings cautiously suggest that depression and anxiety prevention programs based on CBT might have small effects on mental health of adolescents. However, it also indicates that there is still much to be gained for prevention programs. Current findings and possibilities for future research are discussed in order to further improve the effectiveness of targeted prevention on internalizing disorders.
抑郁症和焦虑症是青少年时期最常见的精神障碍之一。在此生命阶段，这些临床疾病的发病率急剧上升，甚至更多青少年患有略低于临床阈值的抑郁或焦虑症状。抑郁或焦虑症状的临床水平和亚临床水平均与社交和学业功能等各个领域的功能下降有关。因此，预防青少年抑郁和焦虑势在必行。我们对基于认知行为疗法的校内和社区预防项目的效果进行了荟萃分析综述，其主要目标是预防高危青少年的抑郁、焦虑或两者兼而有之。通过检索数据库以及手工检索相关文章和综述的参考文献列表来获取文章。筛选过程产生了32篇用于荟萃分析的文章。一篇文章报道了两项研究，三篇文章同时报道了抑郁和焦虑。这导致共有36项研究，其中23项关于抑郁，13项关于焦虑。对于针对高危青少年的抑郁预防，荟萃分析显示干预后预防项目有较小效果，但在3至6个月以及12个月随访时无效果。对于针对高危青少年的焦虑预防，未发现短期效果，在12个月随访时也未发现效果。预防性干预三到六个月后，焦虑症状显著减轻。尽管对抑郁和焦虑症状的影响较小且是暂时的，但当前研究结果谨慎地表明，基于认知行为疗法的抑郁和焦虑预防项目可能对青少年心理健康有较小影响。然而，这也表明预防项目仍有很大的改进空间。为了进一步提高针对内化性障碍的针对性预防的有效性，我们讨论了当前的研究结果和未来研究的可能性。
