Identifying Depression Early in Adolescence (IDEA)

Background: The majority of mental illnesses have their onset by adolescence and early adulthood (Kessler et al, 2007). This  burden of adolescent mental health is disproportionately borne by  youth in low-  and middle-income countries (LMIC) who comprise nearly 90% of the world’s youth and who have the least access to services (Erskine et al,  2015, Kieling et al,  2011, Leckman et al,  2008, Belfer, 2008). Moreover, one out of three suicides worldwide occurs among adolescents in LMIC, accounting for almost 300,000 deaths each year (WHO, 2014). Among mental illnesses, Depression is a leading cause of illness and disability amongst 10-19 year olds and suicide is the third leading cause of death in this age-range (WHO Health for the World’s Adolescents, 2014). Similarly, by the end of adolescence, major depressive disorder (MDD) has a lifetime prevalence of 11% (Avenevoli et al, 2015) and is a major cause of health-related disability across the globe. Despite the wide range of research on depression, we are still lacking instruments to enable us to identify and help adolescents at higher risk of developing depression. There is still a substantial lack of understanding of psychological, social, and neurobiological pathways involved in the development of depression in adolescence and no approach has yet been developed which could help in early prevention of adolescent depression in a global setting. Thus, new ways were proposed to find new ways to identify which adolescents are at risk of depression and how to intervene early to prevent a lifetime of suffering. The project also aimed at collaboration to bring a high income country’s expertise in research, where most of the scientific knowledge about depression and other mental health problems has been produced, to developing countries, where 9 out of 10 children and adolescents live.

Towards this goal, the project was implemented in UK, Brazil, Nepal and Nigeria. In Nepal, we conducted: a) literature review (systematic review and meta-analysis ) of biological, psychological, and social processes associated with increased risk of depression among adolescents and Delphi activity of experts (via email, call, skype) worldwide to develop consensus recommendations for  detecting depression early in adolescence, b)  explore the feasibility and acceptability of conducting high quality and culturally appropriate mental health research (focus on neurobiological research) with adolescents in low-and-middle-income countries (stakeholder workshops, policy level meetings, theory of change workshop c) feasibility and acceptability of early identification and preventive interventions within these contexts via qualitative research methods (key informant interviews, focus group discussions) and d)  dissemination and publication of findings. With the IDEA project, we were to define a set of factors which could help us identify adolescents at risk of developing depression in earlier stage.

Objectives: To identify biological, psychological, social and environmental markers that could help in identification of adolescents at high and low risk of depression.

Target group: The study populations for this study were health workers, school workers, social workers, policy makers, adolescent themselves and parents or guardians of adolescents.

Implementation area:  Kathmandu

Time frame: July 2018 to May 2020

Supported by: George Washington University (GWU) and King’s College London (KCL)


  1. Identifying risk factors and detection strategies for adolescent depression in diverse global settings: A Delphi consensus study
  2. Detection of risk for depression among adolescents in diverse global settings: protocol for the IDEA qualitative study in Brazil, Nepal, Nigeria and the UK
  3. Predicting the risk of depression among adolescents in Nepal using a model developed in Brazil: the IDEA Project


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