Primary prevention in psychiatry--adult populations.

BACKGROUND: The concept of prevention in psychiatry is unique. It includes promotion of mental health, identification of risk factors across the life cycle, and appropriate early interventions. Recent emphasis on intervention early in the development of mental illness has resulted in several preventive programs with varying degrees of success.

METHODS: We reviewed the literature on primary prevention in mental health, categorizing reports as evidence of universal, selective, or indicated prevention.

RESULTS: Indicated prevention through early intervention is the best-researched area of prevention in the spectrum of psychotic disorders, especially schizophrenia. Pharmacotherapy for ultra high-risk individuals combined with cognitive-behavioral therapy (CBT) has shown promising results in several studies. Strategies that teach younger individuals to cope with stress and provide psychosocial support have been effective in preventing mood and anxiety disorders.

CONCLUSIONS: There is evidence that primary prevention may delay the onset of mental illness. Future research on the etiologies of mental illnesses is required to facilitate development of additional primary prevention strategies. These efforts may contribute to reallocation of resources and enactment of public policies that curb the staggering effects of mental illness on society.