Universal school programmes aimed at the prevention of depression and other common mental health problems in adolescents are attractive because they are less stigmatising than targeted interventions, have a high uptake and may shift the ‘normal distribution’ of mental health problems in the positive direction. Research up to now shows small effects of these interventions, but even small effects may have a large impact because of the large number of people receiving these interventions. However, such small effects may also be related to the modest quality of the trials in this area. This means that current research has no clear indication whether universal prevention has a large public health impact or no impact at all. The MYRIAD trial is a large, fully powered, high-quality study showing that universal prevention probably is not effective, although it it is possible that other interventions or approaches do have significant effects. We should seriously consider to move to other approaches to reduce the disease burden of depression in adolescents. Indirect approaches seem to be a feasible and promising alternative approach to prevention and increase the uptake of effective interventions.

中文翻译：

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在学校普遍预防抑郁症：死胡同还是充满挑战的十字路口？

旨在预防青少年抑郁症和其他常见心理健康问题的普及学校计划很有吸引力，因为它们比有针对性的干预措施更少耻辱，具有较高的吸收率，并且可能使心理健康问题的“正常分布”向积极的方向转变。迄今为止的研究表明，这些干预措施的影响很小，但即使是很小的影响也可能产生很大的影响，因为有大量的人接受这些干预措施。然而，如此小的影响也可能与该领域试验的质量不高有关。这意味着目前的研究还没有明确表明普遍预防是否会对公共卫生产生重大影响或根本没有影响。MYRIAD 试验是一项大型、全面、高质量的研究，表明普遍预防可能并不有效，尽管其他干预措施或方法可能确实具有显着效果。我们应该认真考虑采取其他方法来减轻青少年抑郁症的疾病负担。间接方法似乎是一种可行且有前途的预防替代方法，并增加了有效干预措施的采用。