Strengths and limitations
depression, depressed, parental mental illness
DISORDER
The main strength of the current study is its clinical and public health relevance: children with a A further strength of the study is the use of standardized clinical interviews to assess whether the intervention was effective at preventing the onset of depression. These interviews were also administered to assess the inclusion criteria for the study, meaning that we can be fairly sure that none of the children but all parents in the trial experienced a clinically significant episode of depression and not sub-threshold symptoms or a different disorder altogether. Unfortunately, the number of missing interviews, combined with resilience of the sample, meant that our planned analyses were not possible.The main limitations of the current study relate to the generalizability of the findings. Firstly, reflecting the enormous strain that many families with a depressed parent experience, there were large amounts of missing data at all four time points. Other trials of preventive interventions for children of parents with depressed have been terminated early, due to the difficulties families with parental mental illness face to commit to even potentially helpful interventions [A second limitation is that despite the intervention targeting communication within families and parent-child relationships, we did not include a measure of family interaction processes. A final limitation is that we did not systematically collect data on what participants in the CG did during the study period. As such it is hard to be sure whether the positive effects seen in the CG reflect a positive effect of the diagnostic sessions at the beginning of the study, or actions families took once allocated to the CG to compensate for not receiving the intervention.