Monday, September 16, 2013

Cognitive Restructuring Helps Prevent Depression in At-Risk Teens, Study Suggests

A cognitive-behavioral prevention program, when compared with usual care, showed significant sustained effects in preventing depression in teens at high risk for depressive illness, said William Beardslee, M.D., a professor of child psychiatry at Harvard Medical School, and colleagues in JAMA Psychiatry.

The study included 316 youth aged 13 to 17 who were the offspring of parents with current or prior depressive disorders and who themselves had a history of or current depression or had depressive symptoms that did not yet meet criteria for a full-blown depressive disorder. The teens were randomly assigned to usual care or to a cognitive-behavioral prevention (CBP) program in which, during eight weekly group sessions and six monthly group booster sessions, they learned how to deal with negative or unrealistic thoughts. The subjects were evaluated for depression at baseline, after the acute intervention (month 2), after the booster sessions (month 9), and again at one year (month 21) and two years (month 33) after that. Over the 33-month period, and for the sample as a whole, the intervention was shown to be significantly effective. Thirty-seven percent of the teens in the CBP group experienced a depression, compared with 48 percent in the usual-care group. (Usual care was defined as the ability to initiate or continue any non-study mental illness care.)

"We were quite pleased that the effects noted in our earlier analysis nine months after enrollment were sustained at 33 months, as it is difficult to demonstrate longer-term prevention effects," Beardslee told Psychiatric News. At the nine-month follow-up, 21 percent of the teens randomized to the CBP condition had experienced depression, in contrast to 33 percent in the usual-care group.

During the past decade or so, there has been an explosion in mental illness prevention research such as that conducted by Beardslee and his colleagues. See the Psychiatric News article "Future Looks Promising for Mental Illness Prevention" to read more about the research. Also see "Maintenance Cognitive-Behavioral Therapy and Manualized Psychoeducation in the Treatment of Recurrent Depression..." in the American Journal of Psychiatry.

(Image: Gladskikh Tatiana/


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