Primary psychiatric prevention in children and adolescents.

BACKGROUND: Approximately 21% of US children age 9 to 17 have a diagnosable mental illness with some degree of impairment. As early-onset mental illness may persist throughout the life span, effective primary mental health prevention programs are of paramount importance.

METHODS: We conducted a literature review of various preventive programs targeting childhood-onset psychopathology. We attempted to select those programs that present the strongest data on efficacy and those that are most commonly cited.

RESULTS: Modifiable and nonmodifiable risk factors and different primary prevention strategies with positive outcomes have been identified for anxiety disorders, eating disorders, substance abuse, disruptive behavior disorders, and suicide in children. The reported results for attention-deficit/hyperactivity disorder (ADHD) and early-onset schizophrenia are neither uniform nor encouraging.

CONCLUSIONS: Based on our review, there is ample evidence to conclude that primary preventive intervention has the potential to be effective for some mental health disorders, promoting positive development, particularly in children of all ages in high-risk environments. Additional research is needed to further investigate the validity and reliability of various preventive strategies.