Cognitive Behavioral Prevention Program Can Reduce Incidence of Depression Among Teens
Adolescents whose parents have a history of depression are at greater risk for depression themselves. A new study suggests that a cognitive-behavioral prevention program aimed at these teens can reduce depression rates compared to the usual care.
The study, by David A. Brent and colleagues in the journal JAMA Psychiatry, included 316 participants aged 13–17, each of whom had a parent with a current or prior depression. Half of the participants participated in the cognitive-behavioral prevention program in addition to usual care initiated by their families. The program consisted of 8 weeks of 90-minute group sessions focused on developing positive thinking habits and improving problem solving, followed by six monthly sessions. The training was based on the Adolescents Coping with Depression program described in a June 2009 JAMA article by Garber et al.
The group who participated in the prevention program had a lower incidence of depression than the group who received only the usual care, and this difference persisted over six years of followup. Most of this effect was due to a reduced incidence of depression in the first nine months following the intervention. (Depression was roughly equal among the two groups at two later followups.)
Importantly, the benefit of the prevention program was only seen among adolescents whose parents were not depressed at the time of enrollment in the study, underscoring the importance of treating parents in order to keep the whole family healthy.
Benefits of the prevention program included reductions in onset of depression and days depressed, and improvement in interpersonal and academic competence.
Brent and colleagues say that the study shows that it is possible to prevent depression, and this can have long-term developmental consequences. They encourage focusing on the entire family’s mental health treatment.
While the main benefits came early, Brent suggests that booster sessions for teens who begin to show symptoms of depression might refresh the benefits of the prevention program at a later time.
Editor’s Note: This study has enormous health implications as depression in adolescents tends to recur and is associated with a more difficult course than depression beginning in adulthood. Preventing depressions would theoretically have positive consequences for both psychiatric and physical health, as depression is associated with increased risk of suicide and decreased longevity from increases in cardiovascular disease. Researcher Joan Luby recently reported that children with prepubescent onset of depression have decreased hippocampal volume in adolescence, so it is possible that preventing depression may have positive implications for brain volume and function.