Prevention of Major Depression: A Global Priority

Abstract

Prevention of depression and its associated common mental disorders is a priority across the life cycle, and particularly in older adults. Currently available data from randomized clinical trials show that the rate of these disorders can be reduced on average 20–25 % over 1–2 years of follow-up. This is important with respect to: (1) reducing the current burden of suffering, even in the context of subsyndromal symptoms and (2) protection from fully syndromal depression and its down-stream consequences, including poor adherence with co-prescribed medical and behavioral interventions (because depression undermines adherence), family care–giving burden (because depression imposes considerable burden on family as well as patients), suicide (because depression is a major risk factor for suicide in older patients), and dementia (because depression is an important and potentially modifiable risk factor for both vascular and Alzheimer’s dementia). Additional work is needed to clarify biological and psychosocial mediators and moderators of depression prevention intervention; and to build scalable models of depression prevention for low-resource countries.