Preventing depression requires proactive interventions by health-care system

May 14, 2012

Major depressive episodes can be prevented, and to help ensure that they are, the health care system should provide routine access to depression-prevention interventions, just as patients receive standard vaccines, according to a new article co-authored by UCSF researcher Ricardo F. Muñoz, PhD.

The article builds on a 2009 Institute of Medicine report on prevention of mental, emotional and behavioral disorders, which provided presented evidence that mental disorders can be prevented.

The article, "Major Depression Can Be Prevented," will appear in a special section of the May-June 2012 issue of the American Psychologist. In it, the authors provide a road map for what needs to be accomplished in the next 10 years to make headway against depression. Previous studies suggest that 22 percent to 38 percent of major could be prevented with currently available interventions, according to Muñoz.

Muñoz and co-authors William Beardslee, MD, professor of child psychiatry at Harvard Medical School and Yan Leykin, PhD, assistant adjunct professor in the department of psychiatry at UCSF, are calling their article a "call to action for the health care system."

The article offers a set of guidelines, which include identifying high-risk individuals and ultimately striving to reduce new cases of depression by half.

"Very few people are aware that depression can be prevented, including professionals in the field and there are very few preventive services," said Muñoz, a depression prevention and treatment researcher in the department of psychiatry at UCSF and director of the UCSF/San Francisco General Hospital Latino Mental Health Research Program.

"The World Health Organization has named depression the number one cause of disability in the world," he said. Depression can lead to suicide and it causes a significant amount of long-term disability and suffering for the persons afflicted and for their families.

According to Muñoz, only about half of depression cases are recognized and fewer are treated adequately. Many primary care physicians now screen for cases of clinical depression, but there are as yet no recommendations for the identification of patients at risk for depression. The healthcare system itself, he said, is a key roadblock to establishing better preventive services.

"The healthcare system is set up to pay providers for treatment. It has not been set up to pay providers for prevention of mental disorders," said Muñoz. "Without financial incentives for prevention few professionals will engage in preventive interventions. It's a major structural obstacle."

Muñoz is calling for establishing ways to identify people at risk for imminent depression so that they can be offered interventions to prevent it. For example, adolescent children of parents with clinical depression who are starting to experience depressive symptoms have been shown to have significantly fewer full-blown cases of major depression a year or so later if they are provided with mood-management skills and other preventive strategies.

"This two-generational approach, in which parents with depression could obtain interventions to prevent this condition in their children, might have a good chance of being supported and disseminated," he said.

The authors emphasize that preventing depression involves recognizing that depression is a family illness and the needs of family members should be considered. They suggest that different strategies may be appropriate at different points across the lifespan with the same main focus: preventing episodes of depression.

Muñoz and his co-authors advocate teaching people mood management skills shown to be effective for the treatment of depression. "Why wait until people are seriously depressed to teach them these skills?" said Muñoz. "If we can teach these skills earlier, serious depression can be prevented and we could reduce unnecessary suffering significantly."

Once a major depressive episode occurs, the likelihood of having another increases, and this can lead into a chronic, recurrent condition. Stressful life events often trigger depression which then leaves the individual with two problems: the event itself and the depressive episode.

"We have made progress in having the recognize and treat depression," said Muñoz. "Now that there is scientific evidence that depression can be prevented, that the suffering it produces can be averted, and that this suffering is unnecessary, our communities must collaborate to reduce the global impact of ."

Explore further: Group programs to prevent childhood depression prove effective

Related Stories

Group programs to prevent childhood depression prove effective

December 7, 2011
Psychological interventions to prevent depression in children and adolescents can be useful, with protective effects that last for up to a year, finds a new systematic review..

Daily smoking, low mastery associated with repeat episodes of depression

October 24, 2011
Previous depression, daily smoking and a lack of control over life circumstances -- or "low mastery" -- are risk factors for repeat episodes of depression, states an article in CMAJ (Canadian Medical Association Journal).

Paper calls for more to be done to help young people with depression

February 1, 2012
Depression is one of the most common mental health problems in young people worldwide, but it often goes unrecognised and untreated. Left untreated, adolescent depression increases the risk of suicide, substance abuse, and ...

Depression in teenage years linked to maternal postnatal depression

June 10, 2011
(Medical Xpress) -- Research by the University of Reading shows that children of postnatally depressed mothers are more likely to suffer from depression themselves than those of non-depressed mothers.

Recommended for you

Researchers crack the smile, describing three types by muscle movement

July 27, 2017
The smile may be the most common and flexible expression, used to reveal some emotions, cover others and manage social interactions that have kept communities secure and organized for millennia.

Even babies can tell who's the boss, UW research says

July 27, 2017
The charismatic colleague, the natural leader, the life of the party - all are personal qualities that adults recognize instinctively. These socially dominant types, according to repeated studies, also tend to accomplish ...

Infants know what we like best, study finds

July 27, 2017
Behind the chubby cheeks and bright eyes of babies as young as 8 months lies the smoothly whirring mind of a social statistician, logging our every move and making odds on what a person is most likely to do next, suggests ...

DREAMers at greater risk for mental health distress

July 27, 2017
Immigrants who came to the United States illegally as small children and who meet the requirements of the Development Relief and Education for Alien Minors Act, more commonly known as DREAMers, are at risk for mental health ...

Ketamine for depression encouraging, but questions remain around long-term use

July 27, 2017
A world-first systematic review into the safety of ketamine as a treatment for depression, published in the prestigious Lancet Psychiatry, shows the risks of long-term ketamine treatment remain unclear.

Negativity, be gone—new online tool can retrain your brain

July 27, 2017
Anxiety and depression can have devastating effects on people's lives. In some cases, the mental disorders lead to isolation, poverty and poor physical health, things that often cascade to future generations.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.