Background Depression is common in young people, has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health. Objectives To determine whether psychological or educational interventions, or both, are effective in preventing the onset of depressive disorder in children and adolescents. Search methods The Cochrane Depression, Anxiety and Neurosis Review Group's trials registers (CCDANCTR) were searched at the editorial base in July 2010. Update searches of MEDLINE, EMBASE, PsycINFO and ERIC were conducted by the authors in September 2009. Conference abstracts, reference lists of included studies and reviews were searched and experts in the field contacted. Selection criteria Randomised controlled trials of psychological or educational prevention programmes, or both, compared with placebo, any comparison intervention, or no intervention for young people aged 5 to 19 years-old, who did not currently meet diagnostic criteria for depression or who were below the clinical range on standardised, validated, and reliable rating scales of depression, or both, were included. Data collection and analysis Two authors independently assessed studies for inclusion and rated their quality. Sample sizes were adjusted to take account of cluster designs and multiple comparisons. We contacted study authors for additional information where needed. 1 Psychological and educational interventions for preventing depression in children and adolescents (Review)

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BackgroundPrevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations.ObjectiveTo develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants’ self-reported satisfaction with the intervention.MethodsThe intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011.ResultsA total of 1348 students (13–17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)—significantly higher than proportions in the control group.ConclusionsKey messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage.ClinicalTrialAustralia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb)

BackgroundDepression is common in young people, has a marked negative impact and is associated with self‐harm and suicide. Preventing its onset would be an important advance in public health.ObjectivesTo determine whether psychological or educational interventions, or both, are effective in preventing the onset of depressive disorder in children and adolescents.Search methodsThe Cochrane Depression, Anxiety and Neurosis Review Group's trials registers (CCDANCTR) were searched at the editorial base in July 2010. Update searches of MEDLINE, EMBASE, PsycINFO and ERIC were conducted by the authors in September 2009. Conference abstracts, reference lists of included studies and reviews were searched and experts in the field contacted.Selection criteriaRandomised controlled trials of psychological or educational prevention programmes, or both, compared with placebo, any comparison intervention, or no intervention for young people aged 5 to 19 years‐old, who did not currently meet diagnostic criteria for depression or who were below the clinical range on standardised, validated, and reliable rating scales of depression, or both, were included.Data collection and analysisTwo authors independently assessed studies for inclusion and rated their quality. Sample sizes were adjusted to take account of cluster designs and multiple comparisons. We contacted study authors for additional information where needed. Main resultsFifty‐three studies including 14,406 participants were included in the analysis. There were only six studies with clear allocation concealment, participants and assessors were mostly not blind to the intervention or blinding was unclear so that the overall risk of bias was moderately high. Sixteen studies including 3240 participants reported outcomes on depressive diagnosis. The risk of having a depressive disorder post‐intervention was reduced immediately compared with no intervention (15 studies; 3115 participants risk difference (RD) ‐0.09; 95% confidence interval (CI) ‐0.14 to ‐0.05; P<0.0003), at three to nine months (14 studies; 1842 participants; RD ‐0.11; 95% CI ‐0.16 to ‐0.06) and at 12 months (10 studies; 1750 participants; RD ‐0.06; 95% CI ‐0.11 to ‐0.01). There was no evidence for continued efficacy at 24 months (eight studies; 2084 participant; RD ‐0.01; 95% CI ‐0.04 to 0.03) but limited evidence of efficacy at 36 months (two studies; 464 participants; RD ‐0.10; 95% CI ‐0.19 to ‐0.02). There was significant heterogeneity in all these findings. There was no evidence of efficacy in the few studies that compared intervention with placebo or attention controls.Authors' conclusionsThere is some evidence from this review that targeted and universal depression prevention programmes may prevent the onset of depressive disorders compared with no intervention. However, allocation concealment is unclear in most studies, and there is heterogeneity in the findings. The persistence of findings suggests that this is real and not a placebo effect. Plain Language SummaryPsychological and educational interventions for preventing depression in children and adolescentsDepressive disorder is common and has a major impact on the functioning of young people. The aim of this review was to assess the effectiveness of programmes designed to prevent its onset.We found that, compared with no intervention, psychological depression prevention programmes were effective in preventing depression with a number of studies showing a decrease in episodes of depressive illness over a year. There were some problems with the way the studies were done but despite this the results are encouraging. We found data to support both targeted and universal programmes, which is important as universal programmes are likely to be easier to implement. We recommend that further research be undertaken to identify the most effective programmes and to test these in the real world.