Cognitive-Behavioral Prevention Program Associated With Reduced Rate of Depressive Episodes In At-Risk Youth

A cognitive-behavioral prevention (CBP) program appears to sustain positive effects compared with usual care in preventing the onset of depressive episodes in at-risk youth, according to a study by William R. Beardslee, M.D., of Boston Children’s Hospital, and colleagues.

A total of 316 adolescent (ages 13-17 years) children of parents with current and/or prior depressive disorders participated in the randomized clinical trial, with 33 months of follow-up conducted. Adolescents were randomized to either a CBP program of eight weekly 90-minute group sessions followed by six monthly continuation sessions, or usual care (UC). Study participants had histories of depression, current elevated depressive symptoms, or both but did not currently meet criteria for a depressive disorder.

Over the 33-month follow-up period, youths in the CBP condition had significantly fewer onsets of depressive episodes compared with those in UC. Parental depression at baseline significantly moderated the intervention effect. When parents were not depressed at intake, CBP was superior to UC (number needed to treat, six), whereas when parents were actively depressed at baseline, average onset rates between CBP and UC were not significantly different, according to study results.

“Important next steps will be to strengthen the CBP intervention to further enhance its preventive effects, improve intervention outcomes when parents are currently depressed, and conduct larger implementation trials to test the broader public health impact of the CBP program for preventing depression in youth,” the authors conclude.

(JAMA Psychiatry. Published online September 4, 2013. doi:10.1001/jamapsychiatry.2013.295.