As one of the most common, unrecognized and untreated health problems among young people, tackling depression is a serious priority for countries worldwide. The psychiatric disorder causes serious social and educational problems for patients, as well as leading to increased risk of suicide and substance abuse. A review of a published article in The Lancet urges that more measures are needed to prevent depression in non-specialist settings, such as schools and communities.

Anita Thapar from Cardiff University, Cardiff, UK, lead author says:

“In view of the disability associated with depression in adolescents, much more needs to be done to recognise and treat those with depression early and to develop innovative and cost-effective methods to improve access and deliver prevention programmes to a far wider group of adolescents particularly in non-specialist settings and in low-income and middle-income countries where the burden is greatest”

Roughly 5% of adolescents have depression – with the condition being twice as common for girls than boys – with even more being at high risk of developing the disorder. Those at high-risk show symptoms of depression although they don’t have the full-blown disorder. Thapar and colleagues stress the need to target these individuals to prevent full-blown depression from developing:

The researchers wrote:

“Longitudinal studies of adolescents with sub-syndromal depression [high levels of symptoms but not full-blown depression] show that they are at increased risk of later full-blown depressive disorder.

Thus, there are important reasons for paying attention to sub-syndromal depression and targeting individuals with these symptoms for prevention, low-risk intervention strategies, and lifestyle changes.”

Some measures that have been shown to help prevent the disorder for those at risk include:

  • making sure that the adolescents maintain a good relationship with peers and family members
  • introducing coping mechanisms
  • establishing emotional regulation capacities

A prevention strategy for high-risk adolescents, called cognitive behavioural therapy (CBT), has also been found to have a profound effect by reducing the risk of developing depression, through teaching the patient to be optimistic in their thinking.

Interpersonal therapy (IPT) has also had preventive effects, although most countries have a shortage of professionals able to administer the therapies. To make access to CBT and IPT more readily available in non-specialist settings, the authors suggest the introduction of counseling programs in schools and primary care units, and through cheaper options, such as the Internet.

In low-income countries, where resources are scarce, there is a limited amount of treatment and early prevention programs to help those with depression. The implementation of such measures could help ease the burden of depression. In Uganada, adolescent war survivors were given IPT by trained community workers, the impact was substantial in reducing depressive symptoms.

They conclude :

“Evidence for the long term benefits of psychological treatment or medication to rates of recurrence and for the effectiveness of non-specialist interventions is scarce. There is an urgent need for more public education about adolescent depression, and continued research to understand what the key components of prevention programmes and policies ought to be.”

Written by Joseph Nordqvist