Primary prevention: fact or fiction.

This paper is a review of studies oriented to the primary prevention of psychiatric disorder. Difficulties in this field are noted, including current aetiological concepts, outcome measures, techniques and processes, methodological problems, humanitarian and ethical issues and the role of social processes. Studies in several different areas of primary prevention are described. These include projects directed towards parenting processes, vulnerable children, crisis intervention, psychosomatic variables, biological factors, mental health education and community processes. Resistances to preventive work are outlined. It is concluded that much work in this field represents a "call" for prevention; that diffuse interventions for diffuse population groups to achieve diffuse outcomes may not lead to demonstrable effects in prevention. Specific interventions directed towards high risk populations to achieve specific prevention goals have shown that primary prevention may be accomplished in some areas.