An online intervention programme can help prevent depressive episodes among adolescents who are most at risk, a study has found.
Although up to 20 per cent of adolescents experience a depressive episode each year, the medical community has struggled to implement programmes that effectively prevent depression.
Researchers at the University of Illinois at Chicago in the US have worked to fill this gap by conducting clinical trials to evaluate and compare interventions.
The study, published in JAMA Network Open, highlights the positive effect of CATCH-IT, a web-based intervention.
The multicentre, randomised clinical trial compared the CATCH-IT intervention -- which consisted of depression-specific online learning modules, motivational interviews and coaching -- with a control intervention.
The control intervention consisted of general health education and was similarly delivered through online learning modules.
More than 350 adolescents ages 13 to 18 from a mix of rural and urban areas were enrolled in the trial. Participants had either a history of depression or depressive symptoms, which were measured and assigned a score during screening.
The researchers followed the participants for two years and tracked depressive episodes.
While depressive symptoms were reduced across all participants, they found no difference between the groups, except for among higher-risk adolescents whose depressive symptoms scored high on baseline screening.
Among this group, individuals who participated in the CATCH-IT intervention demonstrated greater benefit, achieving as much as 80 per cent risk reduction for experiencing a depressive episode.
"This study tells us that the online intervention works best for teens who are experiencing worse symptoms," said Benjamin Van Voorhees, the principal investigator of the research.
"We hypothesised that there would be a benefit across all participants, but it is perhaps even more telling to see such a significant risk reduction among a smaller group of high-risk adolescents," said Voorhees.
"We need to move depression care away from reactive treatments to widespread prevention, but to be successful we need more research on which interventions work, and for what patients, in primary care settings," Van Voorhees said.
CATCH-IT is an acronym for Competent Adulthood Transition with Cognitive behavioral Humanistic and Interpersonal Training and was designed to teach coping skills to teenagers and young adults.
The intervention included 20 modules, 15 of which were for adolescents. The remaining five were for parents. The information in the modules was based primarily on previously validated educational materials on coping with depression and behavioral and interpersonal psychotherapy methods.
Example modules included lessons on ways to escape negative thoughts, identifying triggers and habitual responses, and how to solve problems in stressful situations.
The control group intervention consisted of 14 modules for adolescents and four modules for parents that provided instruction on general health topics, such as good nutrition, sleep, exercise and safety habits.
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