MONDAY, June 26 (HealthDay News) -- Selective and indicated programs targeting children at risk for depression are better for treatment and prevention of the disease than universal programs, according to a report in the June issue of the Journal of Consulting and Clinical Psychology.

Jason Horowitz, M.S., and Judy Garber, Ph.D., from Vanderbilt University in Nashville, Tenn., conducted a meta-analysis of 30 studies, encompassing 20 years of research, to determine whether treatment and prevention programs designed to identify children and adolescents who are at risk for depression or already have symptoms work better than universal programs.

Universal programs avoid singling out individuals and have lower dropout rates, according to the authors. However, selective programs that identify predisposing factors (such as parents' divorce or recent deaths in the family) produced a larger effect size in reducing depressive symptoms. Indicated programs that identify children who already have depressive symptoms are also more effective than universal programs, the researchers found.

"Most effective interventions are more accurately described as treatment rather than prevention," the authors added. Only four of the 30 studies showed some positive effect on prevention. The authors suggest that further research should focus on groups with a high prevalence of depression, such as female adolescents, and should include longer follow-ups.

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