EVIDENCE BASED STRATEGIES AND INTERVENTIONS FOR PREVENTING DEPRESSION

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Geetu Singh, MD , M.L.B. MEDICAL COLLEGE,JHANSI,INDIA, AGRA, India
INTRODUCTION:  The WHO Mental Health Action Plan (2013-2020) recognizes essential role of mental health in achieving Health for All. Depression is a significant contributor to the global burden of disease. WHO estimates that by 2020, depression will be major cause of disability worldwide. Depression has multiple determinants so, its prevention needs to be a multipronged effort. This paper aims to provide an overview of existing evidence-based interventions for preventing depression.

METHODS:  A comprehensive literature search and review of articles on effective strategies and evidence-based interventions for preventing depression was done.

RESULTS:  A recent Cochrane Review (2013) of 55 randomized controlled trials (RCTs) on psychological and educational depression prevention programs found that both universal and targeted programs reduced depressive symptoms. One six-year RCT on school-based programs for children of divorced parents revealed 11% of adolescents in experimental group had depression compared with 23.5% in control group. Another large RCT found that Mindfulness Based Cognitive Therapy (MBCT) was more effective than maintenance pharmacotherapy in reducing depression and that, 75% in the MBCT Group discontinued antidepressants. The job search (JOBS) programs, tested and replicated in large randomized trials showed increased job search self-efficacy and reduced depression. A Study on 1,046 women found that a “traditional diet” was associated with lower odds for major depression in contrast to "western diet”. A Cochrane Review (2012) showed beneficial effects of child obesity prevention programs. Such results could easily be accepted as obesity and depression share a bidirectional relationship. Rapidly developing evidence on the subject suggests that mental, physical illnesses and lifestyle form a triad. Given success of prevention strategies in reducing cardiovascular diseases, mental diseases should be the next target

CONCLUSIONS:  Depression prevention strategies have progressed to evidence-supported and cost-effective interventions. These can be disseminated globally to help millions of people suffering from depression.