This article proposes that universal and targeted preventive interventions should be compared and evaluated in terms of their benefit-cost ratio in achieving population-wide impact on mental disorders and related outcomes. Universal approaches attempt to affect every individual in a population, whereas targeted approaches select candidates for intervention based on screening of demographic or behavioral characteristics. Unique assets and challenges of each approach in achieving population impact in a cost-efficient way are discussed, along with spillover effects, sensitivity and specificity, developmental processes, timing of intervention, and the relation between severity of risk and plasticity. A general targeted-efficiency framework is proposed as a heuristic to evaluate the collective merits of universal and targeted approaches in specific cases. A tiered approach that combines universal and targeted identification strategies is proposed, and examples are described. Issues for high-priority research are identified.

中文翻译：

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年度研究回顾：分配干预措施以实现人口影响的通用和有针对性的策略。

本文建议，在实现全人群对精神障碍和相关结果的影响方面，应根据效益成本比来比较和评估普遍和有针对性的预防干预措施。通用方法试图影响人群中的每个人，而有针对性的方法则根据人口统计学或行为特征的筛选来选择干预对象。讨论了以具有成本效益的方式实现人口影响的每种方法的独特资产和挑战，以及溢出效应、敏感性和特异性、发展过程、干预时间以及风险严重程度与可塑性之间的关系。提出了一个通用的有针对性的效率框架作为一种启发式方法，用于评估特定情况下通用和有针对性的方法的集体优点。提出了一种结合通用和有针对性的识别策略的分层方法，并描述了示例。确定了高优先级研究的问题。