Effectiveness of a brief school-based intervention on depression, anxiety, hyperactivity, and delinquency: a cluster randomized controlled trial.

Problematic substance use and mental health problems often co-occur in adolescents. Effective school-based interventions that are brief and target multiple problems are promising in the field of health promotion. Preventure is a brief, school-based, selective preventive intervention, tailored to four personality profiles. Preventure has already proved effective on alcohol outcomes. Previous trials also reveal effects on several mental health outcomes, yet the evidence for these outcomes is limited. This study presents the results of the Dutch Preventure Trial, on a range of mental health outcomes. In a cluster RCT, including 699 high risk students (mean age 14 years), the intervention effects on mental health problems at 2, 6, and 12 months post intervention were tested in the total high risk population and in four specific personality groups. No significant intervention effects were found on 22 from the 24 tests. A positive intervention effect on anxiety was found in the anxiety sensitivity personality group at 12-month follow-up, and a negative intervention effect on depression was found at 12-month follow-up in the negative thinking group. In post hoc growth curve analyses these effects were not found. This study found no convincing evidence for the effectiveness of Preventure in The Netherlands on mental health problems. This finding is not in line with the results of an earlier effectiveness study in the UK. This highlights the need for more research into the knowledge transfer model of interventions, to ensure that interventions are effective in a variety of circumstances.

Mood and anxiety disorders in widowhood: a systematic review.

The association between widowhood and mental health problems, such as depressive symptomatology and anxiety, has been examined extensively. Few studies, however, have explored the prevalence and incidence of mood and anxiety disorders based on diagnostic criteria after the loss of the partner. We conducted a systematic review, and searched major bibliographical databases for studies examining mood and anxiety disorders in widowhood. We included all studies examining the prevalence or incidence of mood and anxiety disorders in the widowed, according to diagnostic criteria as assessed with a structured diagnostic interview. Eleven studies were identified, exploring the prevalence and incidence of mood and anxiety disorders in 3,481 widowed individuals and 4,685 non-widowed controls. As expected, the prevalence of Major Depressive Disorder (MDD) and anxiety disorders were considerably elevated in widowed individuals, especially in the first year after the loss of a spouse. During the first year of bereavement, almost 22% of the widowed were diagnosed as having MDD; almost 12% met diagnostic criteria for Post Traumatic Stress Disorder; and there were higher risks of Panic Disorder and Generalized Anxiety Disorder. The incidence rate of MDD and several anxiety disorders ranged from 0.08-0.50. The relative risk of developing a mood or anxiety disorder ranged from 3.49-9.76, in the widowed, compared to control subjects.