Abstract
BackgroundAdolescent depression is a global mental health concern. Identification and effective prevention in an early stage are necessary. The present randomized, controlled trial aimed to examine the effectiveness of Cognitive Behavioral Therapy (CBT)-based depression prevention in adolescents with elevated depressive symptoms. This prevention approach is implemented in school communities, which allows to examine effects under real-life circumstances.MethodsA total of 5222 adolescents were screened for elevated depressive symptoms in the second grade of secondary schools; 130 adolescents aged between 12 and 16 years old (M = 13.59; SD = 0.68; 63.8% girls) were randomly assigned to the experimental (OVK 2.0) or control condition (psycho-education). Self- and parent-reported depressive symptoms were assessed at pretest and post intervention, as well as 6- and 12-months follow-up. Clinical assessment of depression was assessed at pretest and 6-months follow-up.ResultsIntent-to-treat analyses revealed that the decrease in adolescent-rated depressive symptoms was significantly larger in the intervention condition than in the control condition. There was no significant difference in decrease of parent-rated depressive symptoms between both conditions.ConclusionsBased on the findings, we recommend the implementation of screening and prevention in schools, according the basics of this study design. Since this is a new step forward, we discuss the clinical impact and challenges, as well possibilities for future research.Trial registrationThe study is registered in the Dutch Trial Register for RCT’s (NTR5725). Date registered: 11 March 2016.
Highlights
Adolescent depression is a global mental health concern
Several prevention programs worldwide were developed and examined on three levels: (1) universal prevention, which is aimed at all individuals; (2) selective prevention, which is aimed at individuals at risk for depression; and (3) indicated prevention, which is aimed at individuals with elevated depressive symptoms [10]
Present study The purpose of the current study was to evaluate the effectiveness of a Cognitive Behavioral Therapy (CBT) depression prevention program— Op Volle Kracht 2.0 (OVK 2.0, which translates to At Full Force)—as implemented in school communities in the prevention of depression for adolescents with elevated depressive symptoms
Summary
Adolescent depression is a global mental health concern. Identification and effective prevention in an early stage are necessary. The present randomized, controlled trial aimed to examine the effectiveness of Cognitive Behavioral Therapy (CBT)-based depression prevention in adolescents with elevated depressive symptoms. This prevention approach is implemented in school communities, which allows to examine effects under real-life circumstances. Meta-analyses have established that depression prevention programs among adolescents are more effective in reducing depressive symptoms than usual care, waiting lists, or monitoring conditions with the largest effect sizes for selective and indicated prevention [10,11,12,13]. The effects are small to moderate and outcomes are heterogeneous, it seems important to continue with implementing and evaluating selective and indicated prevention programs for depression [11]
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