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Depression creates more burden globally than nearly any other physical or mental disorder, yet surprisingly, little is known about what can be done to prevent its onset and, as Duarte et al.,1 in this issue of JAACAP, address, what the long-term outcomes of youth depression are. The existing medical literature on outcomes of child and adolescent depression is large enough for 2 recent reviews,2,3 which point out the key gaps in our understanding. Does childhood depression actually worsen adult outcomes, or is the driver re