A randomized placebo-controlled trial of a school-based depression prevention program.

Abstract:

OBJECTIVE:To conduct a placebo-controlled study of the effectiveness of a universal school-based depression prevention program. METHOD:Three hundred ninety-two students age 13 to 15 from two schools were randomized to intervention (RAP-Kiwi) and placebo programs run by teachers. RAP-Kiwi was an 11-session manual-based program derived from cognitive-behavioral therapy. The placebo was similar but with cognitive components removed. Outcomes were self-rated depression scales, the Reynolds Adolescent Depression Scale (RADS), and the Beck Depression Inventory II (BDI-II). Follow-up was to 18 months. Analysis was done on an intent-to-treat basis. RESULTS:Immediately after the intervention, depression scores were reduced significantly more by RAP-Kiwi than by placebo, with a mean difference in change from baseline between groups of 1.5 on BDI-II (CI > 0.38, p =.01) and 2.24 on RADS (CI > 0.22, p =.04). Categorical analysis confirmed significant clinical benefit with an absolute risk reduction of 3% (95% CI, 1-11%, McNemar chi, p =.03), with the "number needed to treat" for short-term benefit of 33. Group differences in depression scores averaged across time to 18 months were significant on RADS but not on BDI-II. Retention rates were 91% at 6 months and 72% at 18 months. CONCLUSIONS:The RAP-Kiwi program is a potentially effective public health measure. Confirmation of effectiveness measuring episodes of depressive illness and broader measures of adjustment is warranted.

authors

Merry S,McDowell H,Wild CJ,Bir J,Cunliffe R

doi

10.1097/00004583-200405000-00007

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

538-47

issue

5

eissn

0890-8567

issn

1527-5418

pii

S0890-8567(09)61294-6

journal_volume

43

pub_type

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