مداخلات روانشناختی در افسردگی نوجوانان: بررسی سیستماتیک Psychoeducational interventions in adolescent depression: A systematic review

1. Introduction Depression is common in adolescence, and leads to distress for the young person and their family/carer. It is associated with social and educational impairments. It also predicts suicide, deliberate self-harm and poor physical health, and can mark the beginning of long-term mental health difficulties [1]. Early treatment and prevention of adolescent depression is therefore a major public health concern [2]. However, depression is difficult to recognise and treat in this age group, and engaging young people in prevention and early intervention programmes is a challenge for health and other services [3]. Guidelines for depression in young people (e.g. National Institute for Health and Care Excellence (NICE) [4]; American Academy of Child and Adolescent Psychiatry (AACAP) [5]) stress the need for good information and evidence-based psychosocial interventions for the young person, family and carer. Psychosocial interventions are likely to be important in young people for promoting resilience and preventing relapse [1,6]. Whilst the risk factors and possible causes of adolescent depression are complex, individuals with a family history of depression and psychosocial stress are known to be at a higher risk, and could be targeted for such strategies, along with those with a history of depression [1]. Over recent years there has been growing interest in psychoeducational interventions (PIs); that is the delivery of accurate information to individuals, families and carers about mental health or a specific diagnosis (including possible causes and symptoms), management (including associated risks/side-effects) and prognosis, and how affected individuals can stay well [5,7–9]. Much of the literature on PIs has been in relation to individuals with schizophrenia and bipolar disorder and their families/carers [5,7,10], although there has been increasing interest in depression. Findings from a recent systematic review concluded that PIs are effective in improving the clinical course, treatment adherence, and psychosocial functioning of adults with depression [11]. However, there is no published review on PIs in the prevention and management of adolescent depression. This is an important knowledge gap; depression is more common than bipolar disorder and schizophrenia, and the presentation and management of depression is different in young people compared to adults, as might be their response to PIs. Further investigation could have implications on clinical practice, by informing the way in which practitioners communicate with young people and families/carers regarding depression (and future resources, interventions and guidelines), and raising public awareness of adolescent depression. A systematic review was conducted of the published literature on PIs for adolescents with (or at high risk of) depression. The aim of the review was to i) systematically search and review the literature investigating PIs in the context of adolescent depression; ii) describe the range of PI programmes; iii) summarise the evidence for the effectiveness of different programmes.