School-based interventions are considered a promising effort to prevent the occurrence of mental disorders in adolescents. This systematic review focuses on school-based prevention interventions on depression and anxiety disorders utilizing an RCT design, starting from the year 2000. Based on an online search (PubMed, Scirus, OVID, ISI) and bibliographic findings in the eligible articles, 28 studies providing information were reviewed. The search process ended on 2 May 2011. The majority of interventions turn out to be effective, both for depression (65%) and anxiety (73%). However, the obtained overall mean effect sizes calculated from the most utilized questionnaires can be considered rather small (CDI: -0.12; RCMAS: -0.29). The majority of the reviewed school-based interventions shows effectiveness in reducing or preventing mental disorders in adolescents. However, effect size computation revealed only small-scale effectiveness. Future studies have to consider the impact of program implementation variations.

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▼Yawning often occurs during states of increased sleep propensity. Depression is associated with sleep problems and tiredness. The aim of this paper is to review the present knowledge about possible changes of yawning during an episode of major depression (MD) and to report data on yawning from an online depression forum comprising of 450 000 postings. A literature search did not reveal any study about yawning in people with MD when compared to controls. However, there is evidence for an increased frequency of yawning under the influence of antidepressants. Analysis of the depression forum postings revealed 63 people writing about increased yawning in the context of depression. However, all but one of them were treated with antidepressants; and yawning was not reported as a symptom of depression, but in most cases (N = 56) as occurring as a result of treatment with antidepressants. These findings are in agreement with a tonic hyperarousal in typical depression which is reduced by all standard antidepressants. For clinicians, it would be of interest to know whether yawning is reduced in untreated depression and whether it predicts treatment outcome.

Purpose -The purpose of this paper is to evaluate the health-promoting and stigma-reducing effect of the German school-based programme "Crazy? So what!". Design/methodology/approach -A quasi-experimental longitudinal control-study was carried out with assessments one week prior to the school programme, immediately after it and three months later. A total of 210 Year 9 and 10 students (aged 13-18 years) were surveyed in four schools in Saxony, Germany. Data analysis was done descriptively based on frequency distributions. Random effects regression models for unbalanced panel data were used to estimate the change of the outcome variables over time.Findings -At baseline, only 5.2 per cent of the intervention group would talk with their teacher about a mental health problem. Immediately after the programme, this number increased to 10.6 per cent and after three months to 17.9 per cent. There was also a positive, short-term effect on students' social distance, i.e. an increase in positive attitudes towards those with a mental illness, but this was not sustained over time. By contrast, self-efficacy proved resistant to change. Originality/value -This school programme is successful in that the "experts on their own behalf" (young people, who have gone through mental illness) were able to encourage and reassure others on how to face a mental health crisis with more confidence, which also contributes to strengthening students' resilience. The results of this study indicate the importance of sensitising children and youth, but also teachers and other adults to mental health.

Optimised treatment of depression is important to patients and their families and has important health economic implications in Germany. The optimised treatment of depression can best be achieved with multilevel interventions targeting different groups. The "German Alliance Against Depression" emerged within the framework of the "German Research Network on Depression and Suicidality". This action-oriented programme aims to improve the care of depressed patients through parallel interventions on four levels. These levels are as follows: 1) co-operation with general practitioners, 2) a public relations campaign, 3) training programmes for community facilitators and 4) interventions with high-risk groups. The programme was tested in Nuremberg. Results were promising with a 24% decrease in suicidal behaviour reported. In the meantime, groups in Germany and abroad declared their interest in adapting the programme. Today, close to 40 German regions have implemented similar multilevel interventions. The European Alliance Against Depression (EAAD) formed and now includes 17 countries. The EAAD was mentioned in the 2005 EU green paper on mental health as an "example for best practice". Improving the care of affected persons requires a systematic research approach. The "Mental Health Research Network" contributes to research related to the optimisation of services for persons with mental disorders.