344: Psychological and educational interventions may prevent depression in children and adolescents

January 01, 2012

PEARLS 344, written by Brian R McAvoy.

Clinical question: How effective are psychological and educational interventions in preventing the onset of depression in children and adolescents (aged 5Ð19 years)?

Bottom line: Compared with no intervention, psychological depression prevention programmes were effective in preventing depression, with a number of studies showing a decrease in episodes of depressive illness over a year (NNT=11).* The studies comparing intervention with no intervention showed efficacy at follow-up of 3 to 9 months (and most studies in this group continued follow-up for at least 6 months) and at 12 months, at least for targeted programmes. The effect sizes were small. There was no evidence of efficacy in the few studies that compared intervention with placebo or attention controls. *NNT = number needed to treat to benefit 1 individual

Caveat: Allocation concealment was unclear in most studies, and there was heterogeneity in the findings. There was also a lack of categorisation of the psychotherapies included, although most of the interventions were based on cognitive behavioural therapy strategies. There were few educational programmes in the review, and there was no evidence of efficacy in the few studies that compared intervention with placebo or attention controls.

Context: Depression is common in young people, has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health.

Cochrane Systematic Review: Merry SN et al. Psychological and educational interven.tions for preventing depression in children and adolescents. Cochrane Reviews, 2011, Issue 12. Article No. CD003380. DOI: 10.1002/14651858.CD003380.pub3. This review contains 53 studies involving 14,406 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.