Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research

Abstract

s of preventive intervention programs that used randomized controlled trial design, and a bibliognaphy consisting of more than 2,000 references. The book is divided broadly into two sections. The first, Lessons From Health Research, includes seven chaptens describing the current knowledge base of the field. The historical context ibm prevention research and intervention programs is illuminated, and basic definitions and concepts of risk reduction are presented in detail. After descriptions ofthe status of prevention efforts in three major areas ofphysical illness-cardiovasculam disease, smoking, and injuries-five mental disorders are used to illustrate and elaborate on the various models of preventive intervention. A chapter on the contributions of the cone sciences such as neuroscience and genetics provides a synopsis of our current knowledge about etiology, but it makes the point that preventive interventions can be employed before scientific understanding of a disorder is complete. AIDS and fetal alcohol syndrome are mentioned as examples. An especially significant chapter of the book reports the status of knowledge about risk factors and interventions for Alzheimer’s disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders. Preventive intervention programs and research for individuals across the life-span from infancy to old age are then descnibed. A thoughtful chapter on “Mental Health Promotion” caps the first section. It explains the conceptual and practical differences between preventing diseases and promoting general well-being, and it suggests avenues for examination. The second part of the report, called An Agenda for the Next Decade, describes methodological and ethical issues; issues of culture, ethnicity, and mace; and the role of the community in the developm#{231}nt of prevention interventions. The final chapters summarize the findings and offer clearly enunciated policy statements and recommendations for governmental budgets and structunes that would enhance the pnevention of mental disorders. What I found remarkable about this book is the enormous amount of relevant information it contains and the readable style in which it is presented. Although it is the product of a committee and of numerous contnibutors, it is written with a single voice. Basic definitions are included along with explanations of sophisticared methodological dilemmas, and each policy statement is backed up with precise data. The report will undoubtedly be useful as a resource for policymakers, researchers, and clinicians.