Abstract
BackgroundYouth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression.Methods/designYoung people aged 15–25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change.DiscussionOnline provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12619000234112p. Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol.Protocol version1.0
Highlights
Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning
Reduced autobiographical memory is a cognitive vulnerability for depression that can be improved through intervention, and c-Memory specificity training (MeST) offers an online, cost-effective, brief option that has shown promising results in improving the ability to retrieve specific memories
This study will evaluate the efficacy of computerised version of MeST (c-MeST) in addition to usual care in young people with major depressive episode (MDE)
Summary
Evidence-based treatments for youth depression are available, but many young people do not sufficiently recover with first line options, or relapse. This group is among the most susceptible to poorer long-term prognoses if remission is not achieved. Reduced autobiographical memory is a cognitive vulnerability for depression that can be improved through intervention, and c-MeST offers an online, cost-effective, brief option that has shown promising results in improving the ability to retrieve specific memories. The current study will provide evidence as to whether engaging in repeated practice of retrieving specific autobiographical memories enhances the effects of usual care on depressive symptoms. Trial status Recruitment for the trial began on 12 August 2019 with expected conclusion in late 2020
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