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Evidence Map of Prevention and Treatment Interventions for Depression in Young People

DOI: 10.1155/2012/820735

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Abstract:

Introduction. Depression in adolescents and young people is associated with reduced social, occupational, and interpersonal functioning, increases in suicide and self-harm behaviours, and problematic substance use. Age-appropriate, evidence-based treatments are required to provide optimal care. Methods. “Evidence mapping” methodology was used to quantify the nature and distribution of the extant high-quality research into the prevention and treatment of depression in young people across psychological, medical, and other treatment domains. Results. Prevention research is dominated by cognitive-behavioral- (CBT-) based interventions. Treatment studies predominantly consist of CBT and SSRI medication trials, with few trials of other psychological interventions or complementary/alternative treatments. Quality studies on relapse prevention and treatment for persistent depression are distinctly lacking. Conclusions. This map demonstrates opportunities for future research to address the numerous evidence gaps for interventions to prevent or treat depression in young people, which are of interest to clinical researchers, policy makers, and funding bodies. 1. Introduction Depression among adolescents and young people is a pressing public health issue. A meta-analysis of prevalence rates shows 2.8% of children (<13 years) and 5.7% of adolescents (13–18 years) experience depression over a 12-month period [1]. Depression has serious adverse effects on social, academic, and family functioning [2, 3]. Early onset depression is also associated with higher rates of completed suicide and suicide attempts compared to individuals with no psychiatric illness [4, 5]. High prevalence and the associated disability of depressive disorders make effective, evidence-based prevention and early interventions a priority. While the status of depressive disorders as a public health priority due to the associated burden of disease [6] has ensured a large amount of effort has gone into prevention research, an equally important, but neglected focus has been on early intervention for those with emerging or first episode depression. The age of onset for most disorders, including depressive and anxiety disorders, falls in a narrow time band, predominantly encompassing youth from the early teens to the mid 20’s [7]. Early detection and intervention is critical to preventing a relapsing or chronic course, which is associated with the development of other psychiatric and alcohol and substance use disorders [8, 9], impairments in occupational and social functioning [3, 10–13], and the risk of

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