Resumen: Las enfermedades mentales son comunes, crónicas y discapacitantes, y representan un problema de salud pública importante en nuestro país y en todo el mundo. Para las enfermedades mentales más comunes, disponemos actualmente de intervenciones médicas y psicosociales con eficacia probada. Sin embargo, estas aún son insuficientes, y su disponibilidad no se condice con la alta morbilidad y mortalidad que encontramos para las enfermedades mentales. En respuesta a esto, en los últimos 15 años se ha realizado un esfuerzo considerable para desarrollar técnicas de detección temprana, para personas con alto riesgo clínico de desarrollo de enfermedad mental, e intervenciones precoces para prevenir o retrasar la progresión a la enfermedad completa. Un mayor énfasis en la salud mental y la integración de la atención a la salud mental en todos los programas de desarrollo pertinentes, fortalecerán el esfuerzo general de desarrollo, así como garantizará, por primera vez, la atención sostenida de la inversión y la investigación al principal contribuyente mundial de la pérdida de productividad y carga de enfermedad. Palabras clave: prevención, intervención temprana, salud mental Prevention and early interventions in mental health: an international perspectiveAbstract: Mental diseases are common, chronic and disabling, representing a problem in public health of importance in our country and in the world. For most common mental diseases, currently we dispose of medical and psycho social interventions with proven efficacy. Nevertheless, these are not sufficient yet, and their availability does not diminish the morbidity and mortality produced by mental diseases. In order to solve this, a considerable effort has been carried out in the last 15 years to develop techniques of early detection for persons with high clinical risk to develop mental illness and precocious interventions to prevent or delay the progression of full illness. A greater emphasis in mental health and integrating mental health care in all relevant development programs will strengthen the general development effort, as well as it will ensure, for the first time, sustained attention to investment and research to the main world contributor to loss of productivity and disease burden. Prevenção e intervenções precoces em saúde mental: uma perspectiva internacionalResumo: As enfermidades mentais são comuns, crônicas e descapacitantes, e representam um problema de saúde pública importante em nosso país e em todo o mundo. Para as enfermidades mentais mais comuns dispomos atualmente de intervenções médicas e psicossociais com eficácia comprovada. Entretanto, estas ainda são insuficientes, e sua disponibilidade não condiz com a alta morbidade e mortalidade que encontramos para as enfermidades mentais. Em resposta a isto, nos últimos 15 anos foi realizado um esforço considerável para desenvolver técnicas de detecção precoce para pessoas com alto risco clínico de desenvolvimento de enfermidade mental, e intervenções precoces para prevenir ou atrasar a progressão da enf...

BackgroundOne of the most important risk factors for childhood depression is being the child of a depressed parent. These at-risk children have two to four times the probability of having an affective episode compared with their peers. Preventive interventions such as Beardslee’s Preventive Intervention Program (PIP) that are targeted at children of depressed parents have proven effective in many countries. The PIP is a family-based approach that works by promoting resilience in children and increasing positive interactions within the family. In this pilot randomised controlled trial (RCT), we will determine the acceptability and feasibility of an adapted version of this intervention in Chile.Methods/designWe are conducting a pilot RCT with a manualized intervention. The intervention will be delivered in seven weekly sessions at the family home. It is targeted mostly at parents but will also measure outcomes among the children. Control subjects will follow their treatment as usual. Feasibility and acceptability will be assessed by recruitment, adherence, dropout and level of missing data, as well as the burden of scales and measurement tools. Families will be followed for 11 months.DiscussionGiven the negative lifelong consequences of depression and the burden they represent, preventive programmes are not only feasible but necessary. Despite the successful implementation of this intervention in different countries, an adaptation to the Chilean reality will be prerequisite. The results of this pilot study will inform a definitive trial that will make the case for its national implementation.Trial registrationClinicaltrials.gov trial identifier: NCT02593266. Registration date: 30 Octo 2015.

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