Prevention of major depression

Before the 1980s, no randomized controlled trials had been carried out
to test whether major depressive episodes could be prevented. In the
past 30 years, several trials have reported success in reducing the incidence
(the number of new cases) of major depressive episodes. These
studies suggest that major depression can be prevented. Given the large
burden of disease caused by major depression, it is time for substantial
systematic efforts to replicate these studies, carry out multisite trials,
and widely disseminate prevention interventions found to be effective.
The present review examines the conceptual and practical differences
between treatment and prevention trials and the importance of identifying
groups at high short-term risk for major depressive episodes to
make prevention trials feasible.We also list the randomized controlled
prevention trials that have been carried out to date and discuss the need
for prevention interventions that go beyond the limits of traditional
face-to-face interventions.