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Although nearly 20% of teens experience a depressive episode each year, the medical community has struggled to implement programs that effectively prevent depression.
Researchers at the University of Illinois at Chicago have been working to fill this gap in pediatric primary care by conducting clinical trials to evaluate and compare interventions. A new study published in JAMA Network open now underlines the positive effect of a Web intervention, called CATCH-IT, on the prevention of depressive episodes in most-at-risk adolescents.
The multicenter and randomized clinical trial compared the CATCH-IT intervention – which consists of online learning modules specific to depression, to motivational interviews and coaching – to an intervention. control. The control intervention consisted of general health education and was also delivered through e-learning modules.
More than 350 adolescents aged 13 to 18 from a combination of rural and urban areas were included in the trial. Participants had either a history of depression or depressive symptoms, which were measured and attributed during screening. The researchers followed the participants for two years and followed the depressive episodes.
Although depressive symptoms were reduced in all participants, they found no difference between groups except in higher risk adolescents whose depressive symptoms were elevated during initial screening. Among this group, people who participated in the CATCH-IT intervention showed greater benefits, with a risk reduction of up to 80% in the event of a depressive episode.
"This study tells us that the online intervention works best for teens who exhibit more serious symptoms," said Dr. Benjamin Van Voorhees, the principal investigator. "We hypothesized that there would be a benefit for all participants, but it may be even more telling to see such a significant reduction in risk in a smaller group of teenagers." at high risk. "
Van Voorhees, professor and head of pediatrics at UIC's Faculty of Medicine, said the findings indicate to doctors and researchers that "when it comes to front-line programs for the Prevention of depression, it may be necessary to target scalable solutions on severity patients, not the previous history alone.
"We need to shift the care of depression from responsive treatments to generalized prevention, but to be successful, we need more research about what interventions work and about patients in primary health care settings," Van said. Voorhees. "This is the first study to test a depression prevention intervention in a primary care setting – primary care providers will likely be the first parents to seek help and they will also be among the first to identify disturbing trends in depression. "
"Primary care physicians often recognize sub-threshold depressive symptoms in their adolescent patients, but lack the appropriate means to respond to them," said Tracy Gladstone, Principal Investigator, Assistant Director and Senior Researcher at the Wellesley Centers for Women. Wellesley College. . "We hope this intervention can provide a first-line, evidence-based response to help symptomatic adolescents before they develop a complete depressive illness."
For parents, Van Voorhees said the findings should reinforce the need to act if teens show the first signs of depression.
"If their teenager's behavior changes, parents should not wait to ask for help," he said. "Although this study showed that the online intervention benefited most high-risk adolescents, it also showed that participation in the study, regardless of the group, helped to reduce the symptoms of We know that just doing physical activity, with family, friends and activities can help teens ward off major depressive episodes. "
CATCH-IT is an acronym for "Transition of Competent Adult Life" with humanistic and interpersonal cognitive-behavioral training and has been designed to teach adaptation techniques to adolescents and young adults. The intervention included 20 modules, including 15 for adolescents. The other five were for the parents. The information contained in the modules was based mainly on previously validated teaching materials on the management of depression and methods of behavioral and interpersonal psychotherapy. Examples of modules included lessons on ways to escape negative thoughts, identifying triggers and habitual responses, as well as problem solving in stressful situations.
The focus group intervention included 14 modules for adolescents and four modules for parents, which gave instructions on general health topics, such as proper nutrition, sleep, exercise, and safety habits.
Trial sites included Wellesley College, HealthSystem of NorthShore University, Harvard Vanguard, Advocate Children's Hospital, Access Centers, Franciscan Alliance and UI Health Mile Square Health.
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