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

背景青少年时期患有抑郁和焦虑症的人数大大增加。生活在大城市的青少年更常经历冲突、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-拉丁美洲是世界上城市化程度最高的地区。虽然许多人经历过压力事件，但大多数人不会发展为抑郁或焦虑。此外，当人们确实经历过它们时，多达一半的人在一年内康复。这就提出了一个问题，什么可以帮助人们预防抑郁和焦虑，什么可以帮助人们康复。我们称之为弹性因素。我们的目标是了解弹性因素，以便我们能够开发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恢复有关的弹性因素。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、博戈塔和秘鲁-的青少年。为了实现这一目标，我们的目标是：1。开发新的方法来衡量弹性因素，可用于青少年和年轻人，2。确定哪些弹性因素可以预防抑郁和焦虑，3。确定哪些弹性因素有助于青少年和年轻人在一年内从抑郁和焦虑中恢复过来。就促进预防和恢复的现有办法开展个案研究，5.加强拉丁美洲研究人员的研究技能和知识。让青少年和年轻人参与互动艺术项目。 方法该项目分为六个工作包（WP）。在WP 1中，我们将要求在学校，青年组织和医疗服务机构工作的年轻人和工作人员帮助我们开发测量弹性因素的新方法，以创建评估工具。这项新工具将用于一项研究，将1020名患有抑郁症和焦虑症的青少年（15-16岁）和年轻人（20-24岁）与1020名没有抑郁症和焦虑症的青少年和年轻人进行比较。我们将着眼于个人因素，如健康行为和社会因素，包括关系。我们将测试两组之间是否存在差异。这将有助于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措施。我们将比较那些从抑郁和焦虑中恢复过来的人和那些没有恢复过来的人。这将告诉我们如何恢复。为了促进预防和康复，我们将与已经康复和没有康复的参与者以及不同的利益相关者进行访谈。这将有助于我们确定“良好做法”的领域，我们将把这些领域作为案例研究加以记录。这可能包括诸如保健中心或社区社会团体等倡议（工作方案4）。为了使拉丁美洲的研究人员能够继续研究复原力和恢复，我们将提供以研究技能为重点的培训和活动（WP 5）。最后，我们希望让青少年和年轻人参与我们的研究。为此，我们将开展一个以艺术为基础的项目，要求那些患有抑郁症和焦虑症的人使用照片、电影和涂鸦等不同材料来记录他们的经历。我们将举办展览来展示艺术。我们希望这将鼓励其他年轻人参与研究（WP 6）。预期结果该项目将导致新的知识，什么可以预防抑郁症和焦虑症，什么可以帮助人们康复。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得到广泛传播。虽然该项目侧重于拉丁美洲，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.