Taking Stock of What We Know and What We Need to Know for the Prevention of Depression

This roundtable will discuss how we can most effectively aggregate findings from preventive interventions to inform the next generation of research on the prevention of depression. Prevention trials over the past decade have made significant advances in identifying effective approaches to the prevention of depression. These advances have been documented in multiple meta-analyses as well as narrative reviews. Findings include significant effects to reduce symptoms of depression as well as to reduce the incidence of new cases of depression up to fifteen years following participation in trials. However, the findings also indicate that the effects are moderated by baseline level of depressive symptoms, ethnic minority composition, characteristics of programs and of providers and sites in which the programs are implemented. This roundtable will discuss what we have learned from different efforts to aggregate findings across trials and what are the implications of these findings for the next generation of trials.

Five discussants will contribute different perspectives on this issue. One perspective is from meta-analyses that seek to obtain quantitative estimates of program effect across trials. Five meta-analyses on the prevention of depression have been published over the past decade, and the findings from them have been summarized in a recent overview of meta-analyses of prevention trials. A second perspective is from an emerging approach in which the original data sets across multiple trials are used to quantitatively synthesize findings across trials. A data synthesis approach has particular advantages over traditional meta-analyses in identifying mediators and moderators of prevention trials. A third perspective is that of the prevention scientist who conducts trials on the prevention of depression. Trials on the prevention of depression have become more sophisticated over the past decade and include multiple cite studies, long-term follow-ups of participants and inclusion of multiple components designed to impact both child and family processes. A fourth perspective is type 2 translational research. Moving from carefully controlled efficacy and effectiveness studies to research on the large scale implementation and dissemination of prevention programs involves dealing with multiple challenging issues. The fifth discussants will discuss these issues from the perspective of the NIMH. This round table will consider how findings that have been aggregated across multiple prevention trials can inform research on dissemination and implementation and new questions that need to be investigated to improve program effectiveness.  The discussants will be distinguished researchers who have had extensive experience to represent  these perspectives.