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Preventing Depression in Adolescents

Given the high rates of suicidality and impaired social functioning associated with adolescent depression, preventive interventions are important. In investigating a depression prevention program for teenagers, these investigators took into account 2 known risk factors for adolescent depression -- family history of depression and current depressive symptoms. The researchers identified 2995 depressed parents and their 3374 adolescent offspring (age range, 13 to 18) from an HMO's patient records and then identified 94 of the teenagers as having subsyndromal depression. These patients underwent comprehensive assessment batteries before random assignment to either usual care or 15 one-hour group sessions of cognitive therapy. Teenagers in the cognitive-therapy group attended a mean of 9 sessions. All participants were then followed for 2 years, with annual reassessments. Nine teenagers were not assessed at 1 year; 16 were not assessed at 2 years.

Compared with usual care, cognitive therapy was associated with significantly better scores on both depression and global functioning measures and with significantly fewer episodes of depression during the 2-year follow-up. The positive effects of the intervention diminished, but did not disappear, by the last follow-up.

Comment: The authors acknowledged that few participants were identified for the study, despite wide screening of HMO records. Even with this limitation, these results strongly support continued research on effective preventive methods. The diminished differences between the cognitive-therapy and usual-care groups by 2 years argue for approaches that use "booster" sessions.

— Barbara Geller, MD

Published in Journal Watch Psychiatry January 9, 2002

Citation(s):

Clarke GN et al. A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Arch Gen Psychiatry 2001 Dec; 58:1127-34.

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