A study published in JAMA has shown that group cognitive behavioral therapy may help prevent depression in at-risk teens.
The study had 113 adolescent participants, ages 13 through 17, whose parents had a history of depression. The adolescents had a history of depression, symptoms of depress, or both. They were assigned randomly to the cognitive behavioral therapy (CB) group or to a second group who received only "usual" care. The CB group participated in a prevention program of eight weekly 90-minute group sessions with six monthly continuation sessions in which the adolescents were taught problem-solving skills and cognitive restructuring techniques to counteract unrealistic and overly negative thoughts
At the end of the study...
- depression risk was 37% lower in the group who received CB than in the group who received usual care alone.
- among the adolescents whose parents did not have a history of depression, the CB preventive program was more effective in preventing depression than usual care.
- adolescents also reported feeling less depressed after the course of CB than after usual care.
- adolescents reported feeling less depressed following CB than with usual care only.
- the CB preventive program was effective for adolescents whose parent(s) had a HISTORY of depression.
- the CB preventive program was NOT effective when the adolescents had a CURRENTLY depressed parent.
The researchers noted:
- parental depression is one of the strongest risk factors for adolescents developing depression.
- adolescent depression is strongly related to chronic and recurrent depression as adults.
- the consequences of and difficulty in treating depression in teens show the need for prevention of depression in adolescents.
Summarizing what was learned in the study:
- The cognitive behavioral therapy preventive program was significantly more effective for adolescents than usual care alone when their parents had a history of depression, but not when parents were currently depressed.
- The adolescents themselves said they felt less depressed after the CB program than those who received only usual care.
Points for us to discuss:
- Should all adolescents with a history of depression or symptoms of depression receive CB preventive therapy?
- Should all adolescents whose parents have a history of depression receive CB preventive therapy?
- Should all adolescents whose parents have current depression receive CB preventive therapy?
- Should CB preventive therapy be tried before turning to medications for teens with symptoms of depression?
- Overall, what should the role of CB preventive therapy be for adolescents?
This is an important issue that could have significant impact on adolescents, now and through their adult years as well. It's possible that better use of preventive therapies such as CB for adolescents could reduce the number of adults with depression in the future.
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Phend, Crystal. "Group Therapy Helps At-Risk Teens Avoid Depression." MedPage Today. June 2, 2009.
Judy Garber, PhD; Gregory N. Clarke, PhD; V. Robin Weersing, PhD; William R. Beardslee, MD; David A. Brent, MD; Tracy R. G. Gladstone, PhD; Lynn L. DeBar, PhD; Frances L. Lynch, PhD; Eugene D’Angelo, PhD; Steven D. Hollon, PhD; Wael Shamseddeen, MD, MPH; Satish Iyengar, PhD. "Prevention of Depression in At-Risk Adolescents." JAMA. 2009;301(21):2215-2224.