Identifying prevention strategies for adolescents to reduce their risk of depression: A Delphi consensus study.

BACKGROUND: Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. METHOD: This study employed the Delphi methodology to establish expert consensus on self-help prevention strategies for adolescent depression. A literature search identified 194 recommendations for adolescents. These were presented over three questionnaire rounds to panels of 32 international research and practice experts and 49 consumer advocates, who rated the preventive importance of each recommendation and the feasibility of their implementation by adolescents. RESULTS: 145 strategies were endorsed as likely to be helpful in reducing adolescents׳ risk of developing depression by ≥80% of both panels. Endorsed strategies included messages on mental fitness, personal identity, life skills, healthy relationships, healthy lifestyles, and recreation and leisure. 127 strategies were endorsed as likely to be helpful in reducing risks for depression for both junior and senior adolescents. One strategy was rated as likely to be helpful during the period of junior adolescence only, and 17 strategies were endorsed for the senior adolescent period only. Ratings of the ease of implementing the strategies during the adolescent period accorded by panellists were typically moderate. LIMITATIONS: This study used experts from developed, English-speaking countries; hence the strategies identified may not be for relevant or minority cultures within these countries or for other countries. CONCLUSIONS: This study produced a set of self-help preventive strategies for depression that are supported by research evidence and/or international experts, which can now be promoted in developed English-speaking communities to help adolescents reduce their risk of depression.

Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis.

BACKGROUND: Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety. METHOD: In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations. RESULTS: We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction. LIMITATIONS: This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms. CONCLUSION: The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners.