Abstract
Depression and anxiety disorders are among the most common mental disorders during adolescence. During this life phase, the incidence of these clinical disorders rises dramatically, and even more adolescents suffer from symptoms of depression or anxiety that are just below the clinical threshold. Both clinical and subclinical levels of depression or anxiety symptoms are related to decreased functioning in various areas, such as social and academic functioning. Prevention of depression and anxiety in adolescents is therefore imperative. We conducted a meta-analytic review of the effects of school-based and community-based prevention programs that are based on cognitive behavioral therapy with the primary goal preventing depression, anxiety, or both in high risk adolescents. Articles were obtained by searching databases and hand searching reference lists of relevant articles and reviews. The selection process yielded 32 articles in the meta-analyses. One article reported on two studies and three articles reported on both depression and anxiety. This resulted in a total of 36 studies, 23 on depression and 13 on anxiety. For depression prevention aimed at high risk adolescents, meta-analysis showed a small effect of prevention programs directly after the intervention, but no effect at 3–6 months and at 12 months follow-up. For anxiety prevention aimed at high risk adolescents, no short-term effect was found, nor at 12 months follow-up. Three to six months after the preventive intervention, symptoms of anxiety were significantly decreased. Although effects on depression and anxiety symptoms were small and temporary, current findings cautiously suggest that depression and anxiety prevention programs based on CBT might have small effects on mental health of adolescents. However, it also indicates that there is still much to be gained for prevention programs. Current findings and possibilities for future research are discussed in order to further improve the effectiveness of targeted prevention on internalizing disorders.
Highlights
Depression and anxiety are among the most common mental disorders during adolescence (Kessler et al, 2001; Roza et al, 2003), with a prevalence of 5.6% for depression (Costello et al, 2006; Stallard et al, 2012) and a prevalence of 3–20% for anxiety (Albano et al, 2003)
This review described school-based and community-based prevention programs based on cognitive behavioral therapy with the primary goal of preventing depression and anxiety symptoms in adolescents at risk for developing these disorders
The findings of our study revealed that selective and indicated depression prevention programs using techniques of cognitive behavioral therapy decrease symptoms of depression immediately after the intervention
Summary
Depression and anxiety are among the most common mental disorders during adolescence (Kessler et al, 2001; Roza et al, 2003), with a prevalence of 5.6% for depression (Costello et al, 2006; Stallard et al, 2012) and a prevalence of 3–20% for anxiety (Albano et al, 2003). Adolescents with a depression or anxiety disorder are at considerable risk for developing recurrent depression and anxiety disorders later in life (Pine et al, 1999; Aalto-Setala et al, 2002; Copeland et al, 2014). These negative consequences are comparable between adolescents who meet the criteria for a depression or anxiety disorder and adolescents with subclinical depression and anxiety symptoms (Lewinsohn et al, 2000; Aalto-Setala et al, 2002; Beesdo et al, 2009). Adolescents are, better than younger children, able to understand the concepts that are being taught in the prevention programs due to their improved reasoning (Hankin et al, 1998; Stice et al, 2009)
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