Increasing knowledge about depression in adolescents: effects of an information booklet.

PURPOSE: This study evaluates a newly developed information booklet about depression among adolescents. The aim was to examine the enhancement of knowledge through the booklet with the objective of reducing stigma and facilitating awareness of own treatment needs. METHODS: 628 German ninth graders were enrolled in a pre-post-follow-up study using study-specific questionnaires to investigate knowledge enhancement in seven depression-related topics. Exploratively, knowledge enhancement was calculated with respect to education level and gender. Additionally, the students assessed the booklet's layout, content and utility. Knowledge enhancement was analyzed using repeated measures ANOVA for index values of the booklet's topics. The effect size partial eta square (η²) was computed. RESULTS: The pre-post-follow-up comparison yielded significant knowledge enhancement for all seven index values (p < 0.001). The associated effect sizes were medium to large. The strongest effects were achieved for the categories "Antidepressants" (η² = 0.56), "Symptoms" (η² = 0.45) and "Treatment" (η² = 0.17) of depression as well as for "Suicidality" (η² = 0.36). Although baseline knowledge was high in all students, knowledge enhancement was greater in better educated than in less educated students. Overall assessment of the booklet was good (mean = 2.15 on a rating scale from "very good" (1) to "fail" (6)). CONCLUSIONS: The information booklet as a low-threshold educational approach can significantly enhance depression-specific knowledge in students. Hence, it helps adolescents to acknowledge their own symptoms and treatment needs as well as to recognize these specific mental health problems in their peers. Thus, the booklet can contribute to the reduction of stigma and treatment barriers in adolescents.

[Efficacy of universal and selective prevention on depression in children and adolescents. A systematic review]. / Wirksamkeit universeller und selektiver Prävention von Depression im Kindes- und Jugendalter.

OBJECTIVE: Unipolar depressive disorder often begins in childhood, making it essential to prevent the development of depressive disorders early on. The current review describes the evidence of selective, indicated, and universal prevention of depression in children and adolescents based on published, systematic reviews, and metaanalyses. METHOD: Scientific databases were electronically searched for prevention studies done between 1990 and 2012 with children and adolescents and written in German and English. Ten systematic reviews and metaanalyses were identified as eligible for review. These reviews in turn investigated a total of 121 controlled studies, 52 of which were universal, 46 selective, and 19 targeted prevention studies. Four studies combined selective and indicated prevention. RESULTS: Evidence was found for selective, indicated, and universal prevention in comparison to untreated control groups for efficacy in reducing depressive symptoms in children and adolescents. This was still evident for the follow-up at 3 to 9 months. Evidence for efficacy of selective prevention was still evident at 12 months post-intervention. The effect sizes were mostly low. Compared with placebo the efficacy is considerably lower or no evidence was found. CONCLUSIONS: The results of the single reviews were quite heterogeneous. For further research there is an urgent need to identify the factors responsible for effective programs and to test these under real-world conditions.