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Cited by 285Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 85 of the 85 references it cites were found in a registry or an index.

Psychological and/or educational interventions for the prevention of depression in children and adolescents

Merry, Sally N, McDowell, Heather H, Hetrick, Sarah E, Bir, Julliet J, Muller, N·2004·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd003380.pub2
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Abstract

BACKGROUND: Depression is the fourth most important disease in the estimation of the burden of disease Murray 1996 and is a common problem with prevalence rates estimated to be as high as 8% in young people. Depression in young people is associated with poor academic performance, social dysfunction, substance abuse, suicide attempts, and completed suicide (NHMRC 1997). This has precipitated the development of programmes aimed at preventing the onset of depression. This review evaluates evidence for the effectiveness of these prevention programmes. OBJECTIVES: To determine whether psychological and/or educational interventions (both universal and targeted) are effective in reducing risk of depressive disorder by reducing depressive symptoms immediately after intervention or by preventing the onset of depressive disorder in children and adolescents over the next one to three years. SEARCH STRATEGY: The Cochrane Depression, Anxiety and Neurosis Group trials register (August 2002), MEDLINE (1966 to December Week 3 2002), EMBASE (1980 to January Week 2 2003), PsychInfo (1886 to January Week 2 2003) and ERIC (1985 to December 2002) were searched. In addition, conference abstracts, the reference lists of included studies, and other reviews were searched and experts in the field were contacted. SELECTION CRITERIA: Each identified study was assessed for possible inclusion by two independent reviewers based on the methods sections. The determinants for inclusion were that the trial include a psychological and/or educational prevention programme for young people aged 5 to 19 years-old, who did not meet DSM or ICD criteria for depression and/or did not fall into the clinical range on standardised, validated, and reliable rating scales of depression. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was assessed by two independent reviewers according to a list of pre-determined criteria, which were based on quality ratings devised by Moncrieff and colleagues (Moncrieff 2001). Outcome data was extracted and entered into Revman 4.2. Means and standard deviations for continuous outcomes and number of events for dichotomous outcomes were extracted where available. For trials where the required data were not reported or could not be calculated, further details were requested from first authors. If no further details were provided, the trial was included in the review and described, but not included in the meta-analysis. Results were presented for each type of intervention: targeted or universal interventions; and educational or psychological interventions and if data were provided, by gender. Where possible data were combined in meta-analyses to give a treatment effect across all trials. Sensitivity analysis were conducted on studies rated as "adequate" or "high" quality, that is with a score over 22, based on the scale by Moncrieff et al (Moncrieff 2001). The presence of publication bias was assessed using funnel plots. MAIN RESULTS: Studies were divided into those that compared intervention with an active comparison or placebo (i.e. a control condition that resembles the intervention being investigated but which lacks the elements thought to be active in preventing depression) and those that used a "wait-list" or no intervention comparison group. Only two studies fell into the former category and neither showed effectiveness although one study was inadequately powered to show a difference and in the other the "placebo" contained active therapeutic elements, reducing the ability to demonstrate a difference from intervention. Psychological interventions were effective compared with non-intervention immediately after the programmes were delivered with a significant reduction in scores on depression rating scales for targeted (standardised mean difference (SMD) of -0.26 and a 95% confidence interval (CI) of -0.40 to -0.13 ) but not universal interventions (SMD -0.21, 95% CI -0.48, 0.06), with a significant effect maintained on pooling data (SMD -0.26, 95% CI -0.36, -0.15). While small effect sizes were reported, these were associated with a significant reduction in depressive episodes. The overall risk difference after intervention translates to "numbers needed to treat" (NNT) of 10. The most effective study is the targeted programme by Clarke (Clarke 2001) where the initial effect size of -0.46 is associated with an initial risk difference of -0.22 and NNT 5. There was no evidence of effectiveness for educational interventions. Reports of effectiveness for boys and girls were contradictory. The quality of many studies was poor, and only two studies made allocation concealment explicit. Sensitivity analysis of only high quality studies did not alter the results significantly. The only analysis in which there was significant statistical heterogeneity was the sub-group analysis by gender where there was variability in the response to different programmes for both girls and boys. For the most part fu

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Research works printed but not linked: 22

  1. Cardemil, 2002, The prevention of depressive symptoms in low-income minority middle school students, Prevention and Treatment, 5, Article 8, 10.1037/1522-3736.5.1.58a · DOI
  2. Clarke, 1993, School-based primary prevention of depressive symptomatology in adolescents: Findings from two studies, Journal of Adolescent Research, 8, 183, 10.1177/074355489382004 · DOI
  3. Roberts C Kane R Thompson H Bishop B Hart B The prevention of depressive symptoms in rural school children: A randomized controlled trial Journal of Consulting and Clinical Psychology
  4. Shatte A J Prevention of depressive symptoms in adolescents: Issues of dissemination and mechanisms of change Dissertation Abstracts International: Section B: The Sciences and Engineering 1997
  5. Harper, 1999, A study of adolescent depression, suicide, self-esteem, and family strengths in special education female students compared with regular education female students, Dissertation Abstracts International, 59, 2342
  6. Keeler, 2000, Fresh Start: Treatment effectiveness in a collaborative setting for behaviorally disordered children, Dissertation Abstracts International: Section B: The Sciences and Engineering, 60, 6368
  7. Zubernis, 1999, Prevention of depressive symptoms in preadolescent children of divorce, Journal of Divorce and Remarriage, 30, 11, 10.1300/J087v30n01_02 · DOI
  8. Olmedo, 2000, Gender and previous emotion as predictors of changes in depression and anxiety in adolescence, Ansiedad y Estres, 6, 47
  9. Gillham J Reivich K Shatte A Lascher M Litzinger S Freres D School-based prevention of depressive symptoms In press
  10. Hamilton J Gillham J Patton K Preventing depressive symptoms in the primary care setting In press
  11. Beardslee, Preventive intervention with the children of depressed parents: A case study, Psychoanalytic Study of the Child, 48, 249, 10.1080/00797308.1993.11822387 · DOI
  12. Clarke, 1995, Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: A randomized trial of a group cognitive intervention, Journal of the American Academy of Child and Adolescent Psychiatry, 34, 312, 10.1097/00004583-199503000-00016 · DOI · Paper page
  13. Clarke, 1999, Prevention of depression in at-risk samples of adolescents, 341
  14. Clarke, 2000, Assessment of Study Quality., Section 6
  15. Gillham, 1995, Prevention of depressive symptoms in school-children: Two year follow-up, Psychological Science, 6, 343, 10.1111/j.1467-9280.1995.tb00524.x · DOI
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  19. Mrazek, 1994, Reducing Risks for Mental Disorders. Frontiers for Preventive Research
  20. Murray, 1995, Recommendations for the development of a primary care strategy
  21. 1997, Depression in Young People: Clinical Practice Guidelines
  22. Schulz, 1995, Empirical evidence of bias, Journal of the American Medical Association, 273, 408, 10.1001/jama.273.5.408 · DOI

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Metadata

Authors
Merry, S. N., McDowell, H. H., Hetrick, S. E., Bir, J. J., & Muller, N.
Affiliations
  • University of Auckland (NZ)
  • Orygen Youth Health (AU)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2004-04-19
Issue
1
Pages
CD003380-CD003380
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd003380.pub2
OpenAlex
W1923623012
Cited by
284
References
82
Citations by year
2024: 3 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 6 · 2018: 12 · 2017: 8 · 2016: 17 · 2015: 18 · 2014: 19 · 2013: 13 · 2012: 28
Type
reference entry
Language
en
Open access
closed
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression prevention, childhood depression, adolescent depression, psychological intervention, educational intervention, depressive symptoms, depression onset, intervention effectiveness, methodological quality of trials, suicide prevention, substance use prevention, academic performance, social dysfunction, school-based prevention, family-based prevention, community-based prevention
MeSH terms
Adolescent, Adult, Child, Child, Preschool, Depression, Depressive Disorder, Female, Humans, Male, Psychotherapy, Randomized Controlled Trials as Topic

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