Disorders - Depressive Disorders
Shochet, I. M., Dadds, M.
R., Holland, D., Whitefield, K., Harnett, P. H., Osgarby, S. M.
Evaluated whether a universal school-based program, designed to prevent
depression in adolescents, could be effectively implemented within the constraints of the school environment. Participants were 260 Year 9 secondary
school students. Students completed measures of depressive symptoms and hopelessness and were then assigned to 1 of 3 groups: (a) Resourceful
Adolescent Program-Adolescents (RAP-A), an 11-session school-based resilience building program, as part of the school curriculum; (b) Resourceful
Adolescent Program-Family (RAP-F), the same program as in RAP-A, but in which each student's parents were also invited to participate in a 3-session
parent program; and (c) Adolescent Watch, a comparison group in which adolescents simply completed the measures. The program was implemented with a
high recruitment (88%), low attrition rate (5.8%), and satisfactory adherence to program protocol. Adolescents in either of the RAP programs reported
significantly lower levels of depressive symptomatology and hopelessness at post-intervention and 10-month follow-up, compared with those in the
comparison group. Adolescents also reported high satisfaction with the program. The study provides evidence for the efficacy of a school-based
universal program designed to prevent depression in adolescence.
Journal
of Clinical Child Psychology, 30(3) : 303-15
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Quayle, D., Dziurawiec, S., Roberts, C., Kane, R., Ebsworthy, G.
Depression is a serious mental health problem, affecting more young people than ever before. This research reports on the
short-term effectiveness of an Optimism and Lifeskills Program for preventing depression in preadolescents. A randomised, controlled trial was
conducted with students about to make their transition to high school, in a private girls school. Self-report questionnaires were used to assess the
program's effect on depressive and lonely symptoms, attributional style and self-worth, in a sample of 47 grade 7 girls at posttest and 6-month
follow-up. Results showed fewer depressive symptoms and more positive self-worth in the intervention group compared to the control group at 6-month
follow-up. This research indicates that depression prevention programs can be effective in the short-term and can provide valuable skills to young
making their transition to high school. Implementation issues and suggestions for further research on primary prevention for mental health in schools
are discussed.
Behaviour
Change., 18(4) : 194-203
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Peden, A. R., Rayens, M. K., Hall, L. A., Beebe, L. H.
The authors tested the long-term effectiveness of a cognitive-behavioral group
intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in 92 college women aged 18 to 24 years who ere
at risk for clinical depression. The women were randomly assigned to either an experimental or a no-treatment control group. The experimental group
participated in a 6-week cognitive-behavioral intervention that targeted identification and reduction of negative thinking, using such techniques as
thought stopping and affirmations. Data on depressive symptoms, self-esteem, and negative thinking were collected before the intervention and at
intervals of 1, 6, and 18 months postintervention. The women in the intervention group experienced a greater decrease in depressive symptoms and
negative thinking and a greater increase in self-esteem than those in the control group. The beneficial effects continued over an 18-month follow-up
period. These findings support the importance of thought stopping and affirmations as prevention interventions with at-risk college women.
Journal of American College
Health, 49(6) : 299-306
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Pattison, C., Lynd-Stevenson, R.
The ability of a school-based program with training in both cognitive and
social skills to prevent depressive symptoms in children (the Penn Prevention Program) was evaluated. Research conducted in Australia has failed to
replicate the success of the program in the United States. Also evaluated was the ability of the program to reduce the symptoms of anxiety, the
assumption that changes in social skills and cognitive style would be associated with changes in symptoms of depression and anxiety, and the relative
merits of the cognitive and social components of the program. Sixty-three children in fifth and sixth grades were randomly allocated to intervention
and control groups. There was no evidence that the Penn Prevention Program had any impact on the variables measured at the end of the program or at
the 8-month follow-up assessment. Limitations and implications of the present findings are discussed.
Behaviour Change, 18(2) : 92-102
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Oria, J., Cureton, V. Y., Canham, D.
Depression in adolescence is a common and potentially life-threatening health problem. The
purpose of this study was to evaluate the effects of prevention strategies on decreasing the rate of depression in adolescents. A class addressing
specific skills identified as having an impact on adolescent depression was taught to youth participating in the program. The nonequivalent control
group design was used. The sample consisted of 7th- and 8th-grade students in either the Youth Leadership class or a computer class of a California
middle school. The Childhood Depression Inventory was the instrument used. Nine control group subjects and 11 experimental group subjects completed
both the pretest and the posttest. The analysis of the data revealed no statistically significant differences between the control and experimental
groups. This study should be repeated with larger sample sizes and with greater attention to the timing of pretests and posttests.
Journal of
School Nursing, 17(4) : 204-9
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Lowry-Webster, H. M., Barrett, P. M., Dadds, M. R.
This paper describes the development and preliminary
findings of a program designed to prevent the development of anxiety and depressive symptoms in children aged 10 to 13 years. Using a universal
prevention approach, a total of 594 children were randomly assigned on a class-by-class basis to either a 10-session family group CBT program
(FRIENDS) routinely implemented as part of the school curriculum, or to a comparison group. Pre-post intervention changes were examined universally,
and for children who scored above the clinical cut-off for anxiety at pretest. Results revealed that children in the FRIENDS intervention group
reported fewer anxiety symptoms, regardless of their risk status, than the comparison group at posttest. In terms of reported levels of depression,
only the high anxiety group who completed the FRIENDS intervention evidenced improvements at posttest. Overall, these preliminary results appear to
support the benefits of a school-based universal cognitive-behavioural intervention program. Implications of this study are discussed, and long-term
follow-up measures are currently underway.
Behaviour
Change., 18(1) : 36-50
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Keller, M. B., Ryan, N. D., Strober,
M., Klein, R. G., Kutcher, S. P., Birmaher, B., Hagino, O. R., et-
al
Objective: To compare paroxetine with placebo and
imipramine with placebo for the treatment of adolescent depression. Method: After a 7- to 14-day screening period, 275 adolescents with major
depression began 8 weeks of double-blind paroxetine (20-40 mg), imipramine (gradual upward titration to 200-300 mg), or placebo. The two primary
outcome measures were endpoint response (Hamilton Rating Scale for Depression [HAM-D] score [less-than or equal to]8 or [greater-than or equal to]50%
reduction in baseline HAM-D) and change from baseline HAM-D score. Other depression-related variables were (1) HAM-D depressed mood item; (2)
depression item of the Schedule for Affective Disorders and Schizophrenia for Adolescents-Lifetime version (K-SADS-L); (3) Clinical Global Impression
(CGI) improvement scores of 1 or 2; (4) nine-item depression subscale of K-SADS-L; and (5) mean CGI improvement scores. Results: Paroxetine
demonstrated significantly greater improvement compared with placebo in HAM-D total score [less-than or equal to]8, HAM-D depressed mood item, K-
SADS-L depressed mood item, and CGI score of 1 or 2. The response to imipramine was not significantly different from placebo for any measure. Neither
paroxetine nor imipramine differed significantly from placebo on parent- or self-rating measures. Withdrawal rates for adverse effects were 9.7% and
6.9% for paroxetine and placebo, respectively. Of 31.5% of subjects stopping imipramine therapy because of adverse effects, nearly one third did so
because of adverse cardiovascular effects. Conclusions: Paroxetine is generally well tolerated and effective for major depression in adolescents.
Journal of the
American Academy of Child & Adolescent Psychiatry, 40(7) : 762-772
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants
Joiner-Jr, Thomas E., Voelz, Zachary R., Rudd, M.
Practicing psychologists face
many complexities and challenges in caring for suicidal patients who have comorbid mood and anxiety disorders. Not only must suicidal crises be
addressed, but co-occurring depressive and anxiety symptoms compete for attention as well and are associated with relatively poor clinical prognosis
in usual treatments. The current study compared problem-solving treatment to treatment as usual among depression-anxiety comorbid versus noncomorbid
clinically suicidal young adults. Suicidal patients with mood and anxiety disorders were randomized to the 2 treatments and followed over time.
Comorbid suicidal patients, in particular, experienced notable symptom improvements from the problem-solving treatment. Features of the problem-
solving treatment are described for use in clinical practice. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
Professional Psychology: Research & Practice, 32(3) : 278-
282
- Year: 2001
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST)
Clarke, G. N., Hornbrook, M., Lynch, F., Polen, M., Gale, J., Beardslee, W., O'Connor, E., Seeley, J.
BACKGROUND: Adolescent offspring of depressed parents are at high risk for development of depression.
Cognitive restructuring therapy holds promise for preventing progression to depressive episodes. METHODS: A randomized, controlled trial was
conducted to prevent depressive episodes in at-risk offspring (aged 13-18 years) of adults treated for depression in a health maintenance
organization (HMO). Potential adult cases were found by reviewing the HMO pharmacy records for dispensation of antidepressant medication and the
mental health appointment system. Medical charts were reviewed for a depression diagnosis. Recruitment letters signed by treating physicians were
mailed to adults. Eligible offspring had subdiagnostic depressive symptoms insufficient to meet full DSM-III-R criteria for affective disorder and/or
a past mood disorder. These youth were randomized to usual HMO care (n = 49) or usual care plus a 15-session group cognitive therapy prevention
program (n = 45). RESULTS: We detected significant treatment-by-time (program) effects for the Center for Epidemiological Studies Depression Scale
(P=.005) and the Global Assessment of Functioning scores (P =.04). Survival analysis of incident major depressive episodes during a median 15-month
follow-up found a significant advantage (P =.003) for the experimental condition (9.3% cumulative major depression incidence) compared with the
usual-care control condition (28.8%). CONCLUSION: A brief, group cognitive therapy prevention program can reduce the risk for depression in the
adolescent offspring of parents with a history of depression.
Archives of General Psychiatry, 58(12) : 1127-34
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Bernstein, G. A., Hektner, J. M., Borchardt, C. M., McMillan, M. H.
OBJECTIVE: To conduct a 1-year follow-up of
anxious-depressed school-refusing adolescents who participated in an 8-week study of imipramine versus placebo, each in combination with cognitive-
behavioral therapy. METHOD: Sixty-five percent (41 of 63) of the randomly assigned subjects returned for follow-up evaluation, which consisted of
diagnostic interviews, clinician rating scales for anxiety and depression, family functioning measure, and a questionnaire regarding interim
treatments and school programs. RESULTS: From the adolescent and/or parent perspective, 64.1% met criteria for an anxiety disorder and 33.3% met
criteria for a depressive disorder. Remission rates and acquisition rates for specific anxiety and depressive disorders were determined. In the
follow-up period, 67.5% received at least one psychotropic medication trial and 77.5% had outpatient therapy. Higher level of somatic complaints on
the Anxiety Rating for Children-Revised Physiological subscale at baseline predicted more severe depression on the Children's Depression Rating
Scale-Revised at follow-up (p = .029). CONCLUSIONS: In this naturalistic follow-up study, there was high utilization of mental health interventions.
In addition, a substantial number of subjects met criteria for anxiety and/or depressive disorders 1 year after treatment. Investigation of duration
of acute treatments and evaluation of maintenance treatments for school refusal is needed.
Journal of
the American Academy of Child & Adolescent Psychiatry, 40(2) : 206-13
- Year: 2001
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Birmaher, B., Brent, D. A., Kolko,
D., Baugher, M., Bridge, J., Holder, D., Iyengar, S., Ulloa, R. E.
BACKGROUND: Cognitive behavioral therapy has been shown to be more efficacious than
alternative psychosocial interventions for the acute treatment of adolescents with major depressive disorder. However, the long-term impact of brief
psychosocial interventions on the course of adolescent depression is not well established. METHODS: One hundred seven adolescents with major
depressive disorder randomly assigned to 12 to 16 weeks of cognitive behavioral therapy, systemic behavioral family therapy, or nondirective
supportive therapy were evaluated for 2 years after the psychotherapy trial to document the subsequent course and predictors of major depressive
disorder. RESULTS: There were no long-term differential effects of the 3 psychotherapies. Most participants (80%) recovered (median time, 8.2 months
from baseline), and 30% had a recurrence (median time, 4.2 months from recovery). Twenty-one percent were depressed during at least 80% of the
follow-up period. Severity of depression (at baseline) and presence of self-reported parent-child conflict (at baseline and during the follow-up
period) predicted lack of recovery, chronicity, and recurrence. Despite the similarity to clinically referred patients at baseline, patients
recruited via advertisement were less likely to experience a recurrence. CONCLUSIONS: There were no significant differences in long-term outcome
among cognitive behavioral therapy, systematic behavioral family therapy, and nondirective supportive therapy. While most participants in this study
eventually recovered, those with severe depression and self-perceived parent-child conflict are at greater risk for chronic depression and
recurrences.
Archives of General
Psychiatry, 57(1) : 29-36
- Year: 2000
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy, Supportive
therapy
Bernstein, Gail A., Borchardt, Carrie M., Perwien, Amy R., Crosby, Ross D., Kushner, Matt
G., Thuras, Paul D., Last, Cynthia G.
Investigated the efficacy of 8 wks of imipramine versus placebo in combination with cognitive-behavioral therapy (CBT)
for the treatment of school-refusing adolescents with comorbid anxiety and major depressive disorders. This was a randomized, double-blind trial with
47 adolescents (mean age 13.9 yrs). Over the course of treatment, school attendance improved significantly for the imipramine group but not for the
placebo group. Over the 8 wks of treatment, there was a significant difference between groups on attendance after controlling for baseline
attendance. Anxiety and depression rating scales decreased significantly across treatment for both groups, with depression on the Children's
Depression Rating Scale-Revised decreasing at a significantly faster rate in the imipramine group compared with the placebo group. Imipramine plus
CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school-refusing
adolescents with comorbid anxiety and depression. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 39(3) : 276-
283
- Year: 2000
- Problem: Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tricyclic antidepressants, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)