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This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care.
Methods
We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted.
Results
Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions.
Conclusions
When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.
Crime prevention has a long history in Australia and other parts of the world. In all societies, people have tried to protect themselves and those close to them from assaults and other abuses. This introductory chapter provides an outline for the the text, delineating and explaining the material covered and its core areas of investigation.
The concluding chapter reflects on Tilley’s call for a middle-range radical realism for crime prevention and then outlines some of what the authors believe will be forces, trends and developments that shape crime prevention policy and practice in the coming years. It focuses on potential trends and forces shaping and impacting crime prevention, cybercrime, 'big data', nudging for prevention, prevention science, and crime prevention as a human service.
Politicians and other policy-makers often talk about the ‘rediscovery’ of crime prevention. Such language is misleading. Concepts and principles of social and environmental prevention do not need to be rediscovered or reinvented. If anyone has forgotten about crime prevention, it is politicians and policy-makers. To maintain and enhance their legitimacy, parties and their leaders need to be seen playing direct roles in protecting the public. Crime prevention, however, often works best when it is not so obvious: when it is subtly embedded in everyday routines and activities. This chapter outlines a framework that governments could adopt if they wanted to make prevention a key component of crime policy. It discusses how crime prevention evolved in France, the Netherlands and the United Kingdom, and demonstrates how developments in these countries influenced approaches to crime prevention adopted in Australia. It also suggests ways in which crime prevention policy can be enhanced through a shared version and local crime prevention plans.
This chapter considers environmental crimes and recent criminological responses to these threats, with a view to empasising how the diverse crime prevention interventions discussed throughout this book can be deployed – in this instance with respect to a specific kind of crime. It focuses on eco-crime and crime prevention, approaches to environmental crime prevention, preventing illegal fishing, and tackling organised envirnmental crime. It argues that preventing environmental crime necessarily involves sophisticated, collaborative and multi-dimensional efforts that are tailored to a particular circumstance and commodity.
Implementation failure has been identified as a key problem plaguing crime prevention programs in Australia and abroad. There are numerous reasons for this, including a lack of continuous funding, poor strategy design, ineffective systems to govern implementation, incompatible priorities between central and local government, inadequate political leadership and support among stakeholders, rivalry and an unwillingness to share data between agencies, and insufficient capacity at the local level to facilitate and coordinate program delivery. One factor that confounds the process of implementation is that often it relies upon partnership approaches, with it becoming more challenging to coordinate and achieve strategy outcomes when there are multiple partners participating in a crime prevention program. This chapter discusses an evidence-based approach to crime prevention policy and practice, the challenges of implementing crime prevention strategies, key knowledge and skills to 'do' crime prevention work, factors essential to successful strategy implementation, various evaluation methods, and building capacity for implementation and evaluation.
Theorising relationships between crime and the physical environments in which it occurs has a long history. Environmental theory goes beyond the broken windows and hot-spot approaches, however. Theorists and practitioners can be grouped into two broad schools. The first is concerned with practice in fields such as urban planning and architectural design and maintenance, and has attracted the label CPTED. The second concentrates on more focused interventions in SCP. This chapter covers SCP, CPTED, CPTED theorists and concepts, CPTED in practice, and SCP and CPTED as part of inclusive crime prevention.
This chapter discusses approaches to social prevention, developmental prevention, structure and agency, theory to policy, and the limits of social prevention. It investigates a range of prjects, and asks what progress Australia and other countries have made recently in translating the crime prevention promise apparent in these experiments into effective and sustainable programs. In doing so, it argues that the process has proven difficult, identifying the problem at a political and communicative level. However, difficulties do not just relate to politics and communication. Even among criminologists who agree, in principle, that investment in human capital and infrastructure can have significant prevention benefits, there is little consensus on how such understanding should translate into policy and even whether, at the grassroots level, it is wise to draw too close an association between social intervention and the reduction of crime. These debates have important implications, not just for the ways strategies and programs are designed and implemented but also for the ways they are reviewed and evaluated.
Terrorism involves acts with the intent of coercing or intimidating governments or societies in pursuit of goals that are generally political or ideological. It is this political/ideological component that makes it different from other forms of crime. Radicalisation is a term used to describe the psychological processes that lead to terrorism, with the term 'violent extremism' referring to actions that support ideologically driven violence. This chapter discusses approaches to preventing terrorism and violent extremism, with a focus on the definition of terrorism, the role of police in preventing terrorism, situational approaches to terrorism prevention, and social terrorism prevention. While the prevention of terrorism is the central focus of this chapter, terrorism prevention is also a vehicle to engage with topics that have broader relevance to crime prevention practice. Efforts to prevent terrorism involve all levels of government and rely heavily on policing and intelligence agencies, and also seeks to engage business and the communities to help identity and mitigate terrorism threats.
In attempting to prevent or reduce crime, it is essential that policy-makers and practitioners be prepared to confront two fundamental questions: what are the underlying causes of offending, and which of these causes are most relevant to the crime or crimes currently being addressed? Providing answers to these questions is never straightforward. Almost invariably therefore crime prevention policy and practice will be contested. This chapter investigates disputes and controversies in the crime prevention field, assessing the value of crime prevention through technical and critical paradigms, broad crime prevention classifications, understanding crime in context, and the importance of crime prevention problem-solving.
Many factors contribute to the problem, and it is not surprising therefore that a multifaceted response is needed to address it. Above all, it is essential to de-normalise alcohol-related violence if genuine and effective responses to the problem are to be found. This chapter maps out the relationship between alcohol and violence, and reviews both the key dimensions and dynamics of alcohol-related violence, and approaches to preventing it. In particular, it investigates topics of alcohol and violence, family and domestic violence, responsibilities of the different levels of government in Australia for preventing alcohol-related violence and family and domestic violence. It also investigates various challenges facing practitioners and policy-makers working in these areas, including competing ideological views about how best to prevent these offences, negative unintended consequences of adopting particular approaches, and urban versus rural issues that affect alcohol-related violence.
Crime Prevention: Principles, Perspectives and Practices introduces readers to the theory and practice of crime prevention. Now in its third edition, this book argues for a combination of social and situational/environmental crime prevention strategies as more effective alternatives to policing, criminal justice and 'law and order' approaches. Contending that the principles of prevention can be applied to persistent crime problems such as alcohol-related violence and family and domestic violence, the book explores the prevention of other broad societal harms including terrorism, cybercrime and threats to the environment. The book features useful pedagogy such as case studies, discussion questions and extension topics, as well as new chapters on environmental crime and counter-terrorism. Written by a team of experts in the field of criminology, Crime Prevention remains an authoritative introduction to crime prevention in Australia, and is an invaluable resource for criminology students.