Depression prevention therapy program effective for at-risk youth
Kathryn Doyle (Oct. 07, 2015). Reuters/Globe and Mail. Retrieved from: http://www.theglobeandmail.com/life/health-and-fitness/health/depression-prevention-therapy-program-effective-for-at-risk-youth/article26704201/
A cognitive-behavioural prevention program
to prevent depressive symptoms among at-risk youth may still be
effective years later, according to a new study.
“We
have already shown that the intervention was more effective than usual
care but it is surprising that we are still finding a difference between
groups six years later,” said lead author Dr. David A. Brent of the
University of Pittsburgh Medical Center.
Over time, youngsters in the therapy group
were still at risk for depression but were functioning better at work
and in their interpersonal lives as a result of having more depression
free days, Brent told Reuters Health by email.
The
researchers randomly divided 316 at-risk teens, with prior depressive
episodes of their own and with at least one parent having current or
prior depressive episodes, into two groups between 2003 and 2006.
Teens
in the cognitive-behavioural prevention program attended eight weekly
90-minute group therapy sessions followed by six months of monthly
sessions. The other group did not receive care other than what might
have been initiated by their family members.
Some
teens in each group did develop depression during the study period and
over the six-year follow up period, but it was less common in the
therapy group, the authors reported in JAMA Psychiatry.
Over
the first nine months of the study, those in the therapy group were
about 36 per cent less likely to develop depression than those in the
comparison group.
“Even six years after
the intervention,” the risk of depression was lower for adolescents who
received cognitive-behavioural prevention therapy than for those who
received usual care, the authors reported.
“This
preventive effect largely was driven by the significant difference in
new onsets of depression during the first nine months after enrollment,”
they added, because after that point, the risk of new depressive
episodes was similar in the two groups.
The therapy was most effective for kids whose parents were not depressed when the study began, the authors noted.
“Theoretically,
cognitive behavioral therapy works by changing children’s thinking
patterns - so that they can challenge negative thoughts and not engage
in the kinds of interpretations of events in their lives that lead to
depression,” said Irwin Sandler, director of the Prevention Research
Center at Arizona State University in Tempe, who was not part of the new
study.
The best time to begin this
preventive therapy may be following a parent’s treatment for depression
rather than during treatment, Sandler told Reuters Health by email.
Teens
are actively learning new academic and social skills, and a person who
is depressed most likely will fall behind his or her peers, he said.
“By relieving that depression, he or she will catch up to some degree and that could be reflected years later,” he said.
“Youth
who have had a previous episode of depression should receive some
ongoing help to keep them well, this is now standard care,” he said.
“Youth who are at risk, and may have some symptoms but not full blown
depression would probably benefit from getting (cognitive-behavioral
therapy) earlier, prior to developing a full-blown episode.”
If a child appears to develop depressive symptoms, earlier intervention is better, he said.
Group
therapy sessions cost considerably less than individual sessions, said
Jeremy Pettit, professor of Psychology and Psychiatry at Florida
International University in Miami, who was not part of the new study.
“Even
adolescents who do not respond well to this kind of program in terms of
depression prevention tend to report that they benefited in some ways
from the program and that they are satisfied with the program,” Pettit
told Reuters Health by email.
“Prevention
services are not widely available because our health system does not
reimburse for them, so it’s a real problem, Sandler said. Some programs
are offered through schools or other community agencies, he said.
Not
everything offered as prevention really is evidence based, so parents
need to do their homework and insist on programs that have been
demonstrated to work and where the leaders are certified to be competent
providers of the program, Sandler said.
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