Identifying prevention strategies for adolescents to reduce their risk of depression: A Delphi consensus study.

Background: Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk.

Method: This study employed the Delphi methodology to establish expert consensus on self-help prevention strategies for adolescent depression. A literature search identified 194 recommendations for adolescents. These were presented over three questionnaire rounds to panels of 32 international research and practice experts and 49 consumer advocates, who rated the preventive importance of each recommendation and the feasibility of their implementation by adolescents.

Results: 145 strategies were endorsed as likely to be helpful in reducing adolescents׳ risk of developing depression by ≥80% of both panels. Endorsed strategies included messages on mental fitness, personal identity, life skills, healthy relationships, healthy lifestyles, and recreation and leisure. 127 strategies were endorsed as likely to be helpful in reducing risks for depression for both junior and senior adolescents. One strategy was rated as likely to be helpful during the period of junior adolescence only, and 17 strategies were endorsed for the senior adolescent period only. Ratings of the ease of implementing the strategies during the adolescent period accorded by panellists were typically moderate.

Limitations: This study used experts from developed, English-speaking countries; hence the strategies identified may not be for relevant or minority cultures within these countries or for other countries.

Conclusions: This study produced a set of self-help preventive strategies for depression that are supported by research evidence and/or international experts, which can now be promoted in developed English-speaking communities to help adolescents reduce their risk of depression.