Building resilience and resources to overcome depression and anxiety in young people from urban neighbourhoods in Latin America

背景在青春期，患有抑郁和焦虑的人的数量大大增加。生活在大城市的青少年更容易经历冲突、贫困、滥用药物和社会孤立等压力事件。这包括来自拉丁美洲的青少年--这是世界上城市化程度最高的地区。尽管许多人经历了压力事件，但大多数人既不会抑郁，也不会焦虑。此外，当人们真的经历了这种情况时，多达一半的人会在一年内康复。这就提出了这样一个问题：什么能帮助人们预防抑郁和焦虑，什么能帮助人们恢复健康。我们把这些称为弹性因素。我们的目标是了解弹性因素，这样我们就可以开发出治疗抑郁和焦虑的新方法。总体目标是确定与预防抑郁和焦虑，或与康复有关的弹性因素。我们将重点关注生活在三个拉丁美洲大城市--布宜诺斯艾利斯、波哥大和秘鲁的青少年和年轻人。为了实现这一目标，我们的目标是：1.开发可用于青少年和年轻人的复原力因素的新方法；2.确定哪些复原力因素可以预防抑郁和焦虑；3.确定哪些复原力因素有助于青少年在一年内从抑郁和焦虑中恢复过来；4.开发关于促进预防和康复的现有方法的案例研究；5.提高拉丁美洲研究人员的研究技能和知识；6.通过一个以艺术为基础的互动项目，让青少年和年轻人参与进来。方法该项目被组织成六个工作包(WPS)。在WP1中，我们将要求年轻人和在学校、青年组织和医疗服务机构工作的工作人员帮助我们开发衡量复原力因素的新方法，以创建一种评估工具。新工具将用于一项研究，将1020名患有抑郁和焦虑的青少年(15-16岁)和年轻人(20-24岁)与1020名没有抑郁和焦虑的青少年和年轻人进行比较。我们将考察个人因素，如健康、行为和包括人际关系在内的社会因素。我们将测试这两组人之间是否存在差异。这将帮助我们发现哪些因素与预防有关。患有抑郁症和焦虑症的人将被要求在一年后完成同样的测量。我们将比较那些从抑郁和焦虑中恢复的人和那些没有恢复的人。这将告诉我们有关复苏的情况。为了促进预防和恢复，我们将与康复和未恢复的参与者以及不同的利益攸关方进行面谈。这将帮助我们确定“良好做法”的领域，我们将把这些领域写成案例研究。这可能包括社区中的保健中心或社会团体等倡议(WP4)。为了让拉丁美洲的研究人员能够继续研究复原力和恢复力，我们将提供侧重于研究技能的培训和活动(WP5)。最后，我们希望让青少年和年轻人参与我们的研究。为了做到这一点，我们将运行一个基于艺术的项目，我们将要求那些患有抑郁症和焦虑症的人使用不同的材料，如照片、胶片和涂鸦来记录他们的经历。我们将举办展览来展示这件艺术品。我们希望这将鼓励其他年轻人参与研究(WP6)。预期结果该项目将带来关于什么可以预防抑郁和焦虑以及什么可以帮助人们康复的新知识。了解这一点将有助于我们开发新的方法来改善青少年和年轻人的心理健康，减轻精神障碍的负担。我们的沟通方法将确保研究成果得到广泛传播。尽管该项目的重点是拉丁美洲，但我们的学习将帮助其他国家，包括许多正在变得更加城市化的低收入和中等收入国家。

BackgroundThe numbers of people with depression and anxiety greatly increases during adolescence. Adolescents who live in big cities more commonly experience stressful events such as conflict, poverty, substance misuse and social isolation. This includes adolescents from Latin America - which is the most urban part of the world. Although many individuals experience stressful events, the majority do not develop either depression or anxiety. Furthermore, when people do experience them, up to half recover within a year. This raises the question of what helps people to prevent depression and anxiety, and what helps people recover. We have called these resilience factors. Our aim is to understand resilience factors so we can develop new approaches to treat depression and anxiety. ObjectivesThe overall aim is to identify resilience factors that are linked to either prevention of depression and anxiety, or to recovery. We will focus on adolescents and young people who live in three large Latin American cities - Buenos Aires, Bogotá and Peru. To achieve this, we aim to: 1. Develop new ways of measuring resilience factors that can be used with adolescents and young people,2. Identify which resilience factors prevent depression and anxiety,3. Identify which resilience factors help adolescent and young people to recover from depression and anxiety within one year,4. Develop case studies about existing approaches that promote prevention and recovery, 5. Build up the research skills and knowledge of researchers in Latin America,6. Involve adolescents and young people through an interactive arts-based project. MethodsThe project is organised into six work packages (WPs). In the WP1, we will ask young people and staff who work in schools, youth organisations and healthcare services to help us develop new ways of measuring resilience factors to create an assessment tool. The new tool will be used in a study that will compare 1020 adolescents (15-16 years old) and young people (20-24 years old) with depression and anxiety to 1020 adolescents and young people without. We will look at personal factors such as health behaviours and social factors including relationships. We will test if there are differences between the two groups. This will help us discover which factors are linked to prevention. The individuals who have depression and anxiety will be asked to complete the same measures after one year. We will compare individuals who recovered from depression and anxiety to those who did not. This will tell us about recovery. To promote prevention and recovery we will conduct interviews with participants who did and did not recover and with different stakeholders. This will help us identify areas of "good-practice" which we will write up as case studies. This may include initiatives such as health centres or social-groups in the community (WP4). So that researchers in Latin America can continue studying resilience and recovery, we will provide training and activities focused on research skills (WP5). Finally, we want to involve adolescents and young people in our research. To do this, we will run an arts-based project where we will ask those with depression and anxiety to use different materials such as photographs, films, and graffiti to document their experience. We will hold exhibitions to display the art. We hope this will encourage other young people to get involved in research (WP6).Expected resultsThe project will lead to new knowledge about what prevents depression and anxiety and what help people recover. Understanding this will help us develop new approaches to improve the mental health of adolescents and young people and reduce the burden of mental disorders. Our communication methods will ensure the research is widely disseminated. Although the project focuses on Latin America, our learning will help other countries, including many Low and Middle Income countries, which are becoming more urban.