Abstract
Approximately 20% of people will experience a depressive episode by adulthood, making adolescence an important developmental target for prevention. CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral, Humanistic, and Interpersonal Training), an online depression prevention intervention, has demonstrated efficacy in preventing depressive episodes among adolescents reporting elevated symptoms. Our study examines the effects of CATCH-IT compared to online health education (HE) on internalizing symptoms in adolescents at risk for depression. Participants, ages 13–18, were recruited across eight US health systems and were randomly assigned to CATCH-IT or HE. Assessments were completed at baseline, 2, 6, 12, 18, and 24 months. There were no significant differences between groups in change in depressive symptoms (b = −0.31 for CATCH-IT, b = −0.27 for HE, p = 0.80) or anxiety (b = −0.13 for CATCH-IT, b = −0.11 for HE, p = 0.79). Improvement in depressive symptoms was statistically significant (p < 0.05) for both groups (p = 0.004 for CATCH-IT, p = 0.009 for HE); improvement in anxiety was significant for CATCH-IT (p = 0.04) but not HE (p = 0.07). Parental depression and positive relationships with primary care physicians (PRPC) moderated the anxiety findings, and adolescents’ externalizing symptoms and PRPC moderated the depression findings. This study demonstrates the long-term positive effects of both online programs on depressive symptoms and suggests that CATCH-IT demonstrates cross-over effects for anxiety as well.
Highlights
Depression is a significant public health concern for adolescents
When ODCD was set to 0 in the model, the estimated improvement in depressive symptoms was greater in the CATCH-IT group: slope
In a long-term follow-up investigation, the current study examined symptoms of anxiety and depression in at-risk adolescents who were recruited through primary care and were assigned randomly to the CATCH-IT prevention intervention or health education (HE)
Summary
Depression is a significant public health concern for adolescents. 20% of people will experience a depressive episode before adulthood [1]. Depression is associated with significant impairments in day-to-day functioning, and it can affect developmental trajectories in adolescence and early adulthood [2,3,4]. A single depressive episode increases the risk of future episodes that are often more severe [2,3]. Depressive symptoms, including subthreshold symptoms, are associated with an increased risk of depressive episodes, physical health problems, comorbid mental health concerns, and suicide [4,5,6,7]. The personal and societal cost of depression can be eased through depression prevention interventions [8,9]
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