Prevention of depression: Possibilities and challenges

Abstract

Depressive disorders are highly prevalent, have a high incidence, and are associated with huge losses in quality of life in patients and their relatives, with increased mortality rates, with high levels of service use, and with huge economic costs. Prevention is an alternative to treatment that has not been studied elaborately until now. In this presentation, the current state-of-the-art on prevention of depression will be presented. Some recent methods will be shown to identify high risk groups that can be target populations for these interventions. These studies have made it clear that the majority of the first-ever incident cases of depression can be predicted with some simple risk-indicators. In the next part of the presentation, the research that has been conducted on the effects of preventive interventions will be summarized. In the past decade, several randomised studies have examined the effects of preventive interventions on the incidence of depressive disorders. These studies show that indicated prevention (with subjects who already have some symptoms but no DSM-disorder) can reduce the incidence of major depression with about 30%. Finally, an overview of interventions that are used as prevention in routine practice will be presented. Most of these interventions are based on cognitive-behavior therapy and are aimed at subjects who have some symptoms of depression but do not meet diagnostic criteria for a mood disorder. New developments in the prevention field and innovative interventions that are now being tested, will be presented.