Time Trends in Adolescent Diagnoses of Major Depressive Disorder and Co-occurring Psychiatric Conditions in Electronic Health Records.

Major depressive disorder (MDD) is highly prevalent in youth and generally characterized by psychiatric comorbidities. Secular trends in co-occurring diagnoses remain unclear, especially in healthcare settings. Using large-scale electronic health records data from a major U.

Self-understanding, envisioning the future, and prevention: An appreciation and a reflection on the occasion of the 100th anniversary.

On the 100th birthday of the , it is appropriate to reflect on the evolution of thought on depression prevention research, as seen through a historical perspective, to note how the field has grown and how it can address the issues of today. This article is a personal reflection on one practitioner's evolution of thought on resilience and preventive intervention, starting with interviewing civil rights workers, to conceptualizing self-understanding as an essential component of resilience, to the development of a family-based preventive intervention for parental depression, which was disseminated, adapted, and incorporated into a growing body of prevention research. Consensus statements on mental health prevention from the National Academies are reviewed, and the importance of a social justice perspective is highlighted throughout.

A study protocol for the randomized controlled trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness.

Background: Children of parents with mental illness have an increased risk of developing mental illness themselves throughout their lifespan. This is due to genetic factors but also environmental disadvantages during childhood associated with parental mental illness. Selective primary preventive interventions for the children are recommended to mitigate risk factors and strengthen protective factors, but large-scale, longitudinal studies are needed.

The Transition to Adulthood in Children of Depressed Parents: Long-Term Follow-Up Data from the Family Talk Preventive Intervention Project.

Little is known about the effects of parental depression on offspring as they transition to adulthood-a challenging time developmentally, when late adolescents must separate from home, achieve intimate relationships, and develop a sense of identity. We present long-term quantitative and qualitative data from early adolescents with a depressed parent who were randomized to one of two family-based preventive interventions and followed over time, across the transition to young adulthood. Specifically, we present clinical measures of psychopathology and Likert-scale questionnaire data from young adults and their parents regarding the transition to adulthood and perceptions of the interventions.

Understanding mechanisms of change in a family-based preventive mental health intervention for refugees by refugees in New England.

Transnational migration of refugees is associated with poor mental health, particularly among children. We conducted a pilot trial of the Family Strengthening Intervention for Refugees (FSI-R), using a community-based participatory research (CBPR) approach to deliver a home-based intervention "for refugees by refugees" to improve family functioning and child mental health.  = 80 refugee families in the Greater Boston area participated in the study ( = 40 Somali Bantu families;  = 40 Bhutanese families) with  = 41 families randomized to care-as-usual.

Establishing a path to unity: Recommendations for the Biden/Harris administration.

The Biden/Harris Administration faces many challenges, from systems and policies that do not work for or benefit all Americans to stark social and political divisions. Multiple courses of action will be necessary, and there must be commitment and investment for the "long haul." When considering the nation's challenges, overarching themes emerge that must be addressed.

Community-Level Prevention of Childhood Maltreatment: Next Steps in a World with COVID-19.

Maltreatment of children continues to be a major public health concern, with high social, economic and health burdens. Rates vary by a number of factors that can be categorized into different levels of the social ecology. Research and theory in this field point to the importance of community-level factors that can contribute to either risk or prevention of child maltreatment.

Family-Based Mental Health Promotion for Somali Bantu and Bhutanese Refugees: Feasibility and Acceptability Trial.

Purpose: There are disparities in mental health of refugee youth compared with the general U.S.

Population: We conducted a pilot feasibility and acceptability trial of the home-visiting Family Strengthening Intervention for refugees (FSI-R) using a community-based participatory research approach.

The Association Between Parental Depression and Child Psychosocial Intervention Outcomes: Directions for Future Research.

Recent studies suggest that parental depressive symptoms may affect a child's ability to benefit from interventions for anxiety and depression. This article reviews the current literature, suggesting that, when parents experience current depressive symptoms, children are less likely to benefit from psychosocial interventions for anxiety and depression. Opportunities for future research are discussed, including moderators and mechanisms of the association between parental depressive symptoms and child intervention outcomes.

Cost-Effectiveness of Preventing Depression Among At-Risk Youths: Postintervention and 2-Year Follow-Up.

Objective: Youth depression can be prevented, yet few programs are offered. Decision makers lack cost information. This study evaluated the cost-effectiveness of a cognitive-behavioral prevention program (CBP) versus usual care.

Master Clinician Review: Parental Depression and Family Health and Wellness: What Clinicians Can Do and Reflections on Opportunities for the Future.

The study of parental depression in families with children who are depressed and the development of appropriate family prevention strategies to assist families with parents who are depressed have expanded and improved significantly over the past 30 years. This article highlights an evidence-informed approach for clinicians dealing with parents who are depressed in different settings, addressing when a parent presents with depression, and when parental depression is encountered in treating a child with behavior health concerns. Some reflections on key contextual, policy, and systems issues are offered, because these so often determine what is and is not possible in a clinical encounter.

Family-based promotion of mental health in children affected by HIV: a pilot randomized controlled trial.

Background: Children affected by HIV are at risk for poor mental health. We conducted a pilot randomized controlled trial (RCT) of the Family Strengthening Intervention (FSI-HIV), a family home-visiting intervention to promote mental health and improve parent-child relationships in families with caregivers living with HIV, hypothesizing that child and family outcomes would be superior to usual care social work services.

Methods: Eighty two families (N = 170 children, 48.

Community-Level Approaches to Child Maltreatment Prevention.

Often the focus of the field of child maltreatment has concentrated on identifying and intervening on risk and protective factors at the individual and family levels; however, since the 1970s, the important roles that communities play in both exacerbating and preventing child maltreatment have received attention as well. This article outlines the development of this area of scientific inquiry, describes the theoretical frameworks utilized by existing programs, and describes several community-level programs aimed at preventing child maltreatment that show promise as scalable strategies to enhance individual and family strengths and reduce caregiver stress. Challenges inherent in community-level programming in increasingly diverse environments and in building/maintaining political will for sustainability of evidence-based efforts are discussed as well.

The feasibility and acceptability of a preventive intervention programme for children with depressed parents: study protocol for a randomised controlled trial.

Background: One of the most important risk factors for childhood depression is being the child of a depressed parent. These at-risk children have two to four times the probability of having an affective episode compared with their peers. Preventive interventions such as Beardslee's Preventive Intervention Program (PIP) that are targeted at children of depressed parents have proven effective in many countries.

Prevention of Depression in At-Risk Adolescents: Predictors and Moderators of Acute Effects.

Objective: To assess predictors and moderators of a cognitive-behavioral prevention (CBP) program for adolescent offspring of parents with depression.

Method: This 4-site randomized trial evaluated CBP compared to usual community care (UC) in 310 adolescents with familial (parental depression) and individual (youth history of depression or current subsyndromal symptoms) risk for depression. As previously reported by Garber and colleagues, a significant prevention effect favored CBP through 9 months; however, outcomes of CBP and UC did not significantly differ when parents were depressed at baseline.

Neighborhood-level social processes and substantiated cases of child maltreatment.

Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g.

Effect of a Cognitive-Behavioral Prevention Program on Depression 6 Years After Implementation Among At-Risk Adolescents: A Randomized Clinical Trial.

Importance: Adolescents whose parents have a history of depression are at risk for developing depression and functional impairment. The long-term effects of prevention programs on adolescent depression and functioning are not known.

Objective: To determine whether a cognitive-behavioral prevention (CBP) program reduced the incidence of depressive episodes, increased depression-free days, and improved developmental competence 6 years after implementation.

Increasing Understanding in Children of Depressed Parents: Predictors and Moderators of Intervention Response.

We evaluated predictors and moderators of differential response to two family-based depression prevention programs for families with a depressed parent: a clinician-facilitated intervention and a lecture group intervention. Individual and family level variables were examined using regression analyses with generalized estimating equations. For the outcome of child understanding of depression, parental changes in child-related behaviors and attitudes predicted greater child understanding (p < 0.

An internet-based adolescent depression preventive intervention: study protocol for a randomized control trial.

Background: The high prevalence of major depressive disorder in adolescents and the low rate of successful treatment highlight a pressing need for accessible, affordable adolescent depression prevention programs. The Internet offers opportunities to provide adolescents with high quality, evidence-based programs without burdening or creating new care delivery systems. Internet-based interventions hold promise, but further research is needed to explore the efficacy of these approaches and ways of integrating emerging technologies for behavioral health into the primary care system.

Effect of the Affordable Care Act's young adult insurance expansions on hospital-based mental health care.

Objective: Insurance coverage for young adults has increased since 2010, when the Affordable Care Act (ACA) required insurers to permit children to remain on parental policies until age 26 as dependents. This study estimated the association between the dependent coverage provision and changes in young adults' use of hospital-based services for substance use disorders and non-substance use psychiatric disorders.

Method: The authors conducted a quasi-experimental comparison of a national sample of non-childbirth-related inpatient admissions to general hospitals (a total of 2,670,463 admissions, 430,583 of which had primary psychiatric diagnoses) and California emergency department visits with psychiatric diagnoses (N=11,139,689), using data spanning 2005 to 2011.

Family-based prevention of mental health problems in children affected by HIV and AIDS: an open trial.

Objective: The objective of this study is to assess the feasibility and acceptability of an intervention to reduce mental health problems and bolster resilience among children living in households affected by caregiver HIV in Rwanda.

Design: Pre-post design, including 6-month follow-up.

Methods: The Family Strengthening Intervention (FSI) aims to reduce mental health problems among HIV-affected children through improved child-caregiver relationships, family communication and parenting skills, HIV psychoeducation and connections to resources.

Depression in homeless mothers: addressing an unrecognized public health issue.

Homeless mothers experience disproportionately high rates of major depressive disorder compared with the general population. Stressed by their circumstances, these women struggle to protect their families. Children living with a depressed parent have poorer medical, mental health, and educational outcomes.

Use of hospital-based services among young adults with behavioral health diagnoses before and after health insurance expansions.

Importance: Young adults have high levels of behavioral health needs but often lack health insurance. Recent health reforms have increased coverage, but it is unclear how use of hospital-based care changed after expanding insurance. OBJECTIVE To evaluate the association between health insurance coverage expansions and use of hospital-based care among young adults with behavioral health diagnoses.