Depression and anxiety in young people: How effective are preventative efforts?
Dr Shelley Hyman
Depression and anxiety are very common in young people. Due to the nature of the two disorders, children and adolescents who experience depression often experience anxiety as well, and vice versa. Depression and anxiety tend to persist once established and impact negatively on one’s quality of life. Thus, it is important to focus on preventing depression and anxiety early on, such as in school settings.
There are three main types of preventative efforts. In this case, a universal prevention program is one that would be provided to all young people, regardless of if they are at risk of depression/anxiety or not. Hence, these programs can be easily implemented in schools or communities. On the other hand, a selective prevention program is one that is targeted at those at risk of developing depression and/or anxiety. An indicated prevention program goes one step further, being only provided to individuals who experiencing early signs of depression and/or anxiety. Both selective and indicated prevention programs would likely be delivered as group sessions.
In the first review of its kind, Stockings and colleagues (2016) examined the effectiveness of universal, selective and indicated preventive efforts upon both depression and anxiety among children and adolescents (5-18 years). The researchers conducted a meta-analysis where they evaluated 146 studies, of 46 072 participants in total. 54 studies were trials of universal prevention, 45 studies were trials of selective prevention, and 47 studies were trials of indicated prevention.
Stockings and colleagues (2016) found that regardless of whether a universal, selective, or indicative prevention program was used on children and adolescents, the risk of developing depression and/or anxiety significantly reduced. These reductions in risk were maintained for up to 12 months after the universal program was delivered, but only up to 9 months for the selective and indicated programs.
It seems that universal prevention may lead to greater, long-term gains than the other types of preventative efforts. Preventative efforts also produce greater gains when both depression and anxiety are targeted in the one prevention program.
Hence, it could be that prevention programs delivered in school settings, which target both depression and anxiety, be the most beneficial. Clinicians would not even be required to deliver such programs, as the researchers found school programs are more effective if delivered by teachers and school staff instead. Alternatively, these school programs can be delivered online, a cost-effective and engaging strategy.
Sashika de Silva
- Original article: Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A., & Patton, G. (2015). Preventing depression and anxiety in young people: A review of the joint efficacy of universal, selective and indicated prevention. Psychological Medicine Psychol. Med., 46(01), 11-26.