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Effect of a Cognitive-Behavioral Prevention Program on Depression 6 Years after Implementation among At-Risk Adolescents:  A Randomized Clinical Trial
Brent DA, Brunwasser SM, Hollon SD, Weersing VR, Clarke GN, JF Dickerson, Beardslee WR, Gladstone TRG, Porta G, Lynch FL, Iyengar S and Garber J
JAMA Psychiatry. Published online September 30, 2015

Adolescents whose parents have a history of depression are at risk for developing depression and functional impairment. The long-term effects of prevention programs on adolescent depression and functioning are not known.

In an article published online in JAMA Psychiatry, Dr. David Brent and colleagues reported their findings from a study to determine whether a cognitive-behavioral prevention program reduced the incidence of depressive episodes, increased depression-free days, and improved developmental competence six years after implementation. This four-site randomized clinical trial compared the effect of cognitive behavior prevention plus usual care vs. usual care through follow-up 75 months after the intervention.  Three hundred and sixteen participants ages 13 to 17 years old at the time of enrollment with at least one parent with current or prior depressive episodes were recruited. The cognitive behavior prevention program consisted of eight weekly 90-minute group sessions followed by six monthly continuation sessions. Usual care consisted of any family-initiated mental health treatment.  Investigators used the Depression Symptoms Rating scale to assess the primary outcome, new onsets of depressive episodes, and to calculate depression-free days.  A modified Status Questionnaire assessed developmental competence (e.g., academic or interpersonal) in young adulthood.

Dr. Brent and his collaborators found that over the 75-month follow-up, youths assigned to cognitive behavioral prevention had a lower incidence of depression. The cognitive behavior prevention program’s overall significant effect was driven by a lower incidence of depressive episodes during the first nine months after enrollment. 

Results of this study indicate that the effect of cognitive behavior prevention on new onsets of depression was strongest early and was maintained throughout the follow-up period. The effectiveness of this intervention may be enhanced by additional booster sessions and concomitant treatment of parental depression.

 Contributors:
David A. Brent, MD and Giovanna Porta, MS (Department of Psychiatry, University of Pittsburgh School of Medicine)

 Steven M. Brunwasser, PhD and Judy Garber, PhD3 (Department of Psychology and Human Development, Vanderbilt University)

 Steven D. Hollon, PhD (Department of Psychology, Vanderbilt University)

 V. Robin Weersing, PhD (Joint Doctoral Program in Clinical Psychology, San Diego State University and the University of California, San Diego)

Gregory N. Clarke, PhD, John F. Dickerson, PhD and Frances L. Lynch, PhD (Center for Health Research, Kaiser Permanente Northwest)

William R. Beardslee, MD (Department of Psychiatry, Boston Children’s Hospital)

Tracy R. G. Gladstone, PhD (Wellesley Centers for Women, Wellesley College)

Satish Iyengar, PhD (Department of Statistics, University of Pittsburgh)


This article appears in the journal JAMA Psychiatry.  To view the abstract, click here.