Primary prevention

Stressful life events, history of trauma, chronic illness, and parental depression play important roles in paediatric depression. Efforts to reduce stress and trauma, and to treat parental depression, could potentially decrease the likelihood of depressive disorders in children. School-, community-, or internet-based cognitive behavioural prevention programmes may be a useful preventive measure in at-risk adolescents.[53][54][55] [ Cochrane Clinical Answers logo ] Recent attention has been given to utilising technology in preventing depression. In one New Zealand study of high school students, those who received daily messages over 9 weeks reported that the messages helped them to be more positive and reduce negative thoughts compared with students who did not receive messages.[56] Additional research on the role of technology in prevention and treatment is needed.

Treating other psychiatric illnesses, such as ADHD and anxiety disorders, could also potentially reduce the incidence of depressive disorder.

Secondary prevention

Safety needs to be assessed prior to and throughout the treatment of depression, as suicidal thoughts and behaviours may present during all stages of depression. Frequent follow-up visits during the early phase of treatment and during dose change is important, to monitor adverse effects and to assess safety and treatment response. Risky behaviour, and substance use and abuse, need to be routinely assessed. The treatment also should aim at preventing relapse, as the relapse rate in childhood depression is high.

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