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Article: Effect of Internet-Based Cognitive Behavioral Humanistic and Interpersonal Training vs Internet-Based General Health Education on Adolescent Depression in Primary Care: A Randomized Clinical Trial

TitleEffect of Internet-Based Cognitive Behavioral Humanistic and Interpersonal Training vs Internet-Based General Health Education on Adolescent Depression in Primary Care: A Randomized Clinical Trial
Authors
KeywordsDepression
Cognitive Behavioral Therapy
Adolescents at Risk
Issue Date2018
PublisherAmerican Medical Association: JAMA Network Open. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen
Citation
JAMA Network Open, 2018, v. 1 n. 7, p. article no. e184278 How to Cite?
AbstractImportance: Although 13% to 20% of American adolescents experience a depressive episode annually, no scalable primary care model for adolescent depression prevention is currently available. Objective: To study whether competent adulthood transition with cognitive behavioral humanistic and interpersonal training (CATCH-IT) lowers the hazard for depression in at-risk adolescents identified in primary care, as compared with a general health education (HE) attention control. Design, Setting, and Participants: This multicenter, randomized clinical trial, a phase 3 single-blind study, compares CATCH-IT with HE. Participants were enrolled from 2012 to 2016 and assessed at 2, 6, 12, 18, and 24 months postrandomization in a primary care setting. Eligible adolescents were aged 13 to 18 years with subsyndromal depression and/or history of depression and no current depression diagnosis or treatment. Of 2250 adolescents screened for eligibility, 446 participants completed the baseline interview, and 369 were randomized into CATCH-IT (n = 193) and HE (n = 176). Interventions: The internet-based intervention, CATCH-IT, is a 20-module (15 adolescent modules and 5 parent modules) online psychoeducation course that includes a parent program, supported by 3 motivational interviews. Main Outcomes and Measures: Time to event for depressive episode; depressive symptoms at 6 months. Results: Of 369 participants (mean [SD] age, 15.4 [1.5] years; 251 women [68%]) included in this trial, 193 were randomized into CATCH-IT and 176 into HE. Among these participants, 28% had both a past episode and subsyndromal depression; 12% had a past episode only, 59% had subsyndromal depression only, and 1% had borderline subsyndromal depression. The outcome of time to event favored CATCH-IT but was not significant with intention-to-treat analyses (unadjusted hazard ratio [HR], 0.59; 95% CI, 0.27-1.29; P = .18; adjusted HR, 0.53; 95% CI, 0.23-1.23; P = .14). Adolescents with higher baseline Center for Epidemiologic Studies Depression scale (CES-D10) scores showed a significantly stronger effect of CATCH-IT on time to event relative to those with lower baseline scores (HR 0.82; 95% CI, 0.67-0.99; P = .04). For example, the hazard ratio for a CES-D10 score of 15 was 0.20 (95% CI, 0.05-0.77), compared with a hazard ratio of 1.44 (95% CI, 0.41-5.03) for a CES-D10 score of 5. In both CATCH-IT and HE groups, depression symptoms declined and functional scores increased. Conclusions and Relevance: For preventing depressive episodes CATCH-IT may be better than HE for at-risk adolescents with subsyndromal depression. Also CATCH-IT may be a scalable approach to prevent depressive episodes in adolescents in primary care.
Persistent Identifierhttp://hdl.handle.net/10722/289144
ISSN
2019 Impact Factor: 5.032
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorGladstone, TRG-
dc.contributor.authorTerrizzi, DA-
dc.contributor.authorPaulson, A-
dc.contributor.authorNidetz, J-
dc.contributor.authorCanel, J-
dc.contributor.authorChing, E-
dc.contributor.authorBerry, AD-
dc.contributor.authorCantorna, J-
dc.contributor.authorFogel, J-
dc.contributor.authorEder, M-
dc.contributor.authorBolotin, M-
dc.contributor.authorThomann, LO-
dc.contributor.authorGriffiths, K-
dc.contributor.authorIp, P-
dc.contributor.authorAaby, DA-
dc.contributor.authorBrown, CH-
dc.contributor.authorBeardslee, W-
dc.contributor.authorBell, C-
dc.contributor.authorCrawford, TJ-
dc.contributor.authorFitzgibbon, M-
dc.contributor.authorSchiffer, L-
dc.contributor.authorLiu, N-
dc.contributor.authorMarko-Holguin, M-
dc.contributor.authorVan Voorhees, BW-
dc.date.accessioned2020-10-22T08:08:26Z-
dc.date.available2020-10-22T08:08:26Z-
dc.date.issued2018-
dc.identifier.citationJAMA Network Open, 2018, v. 1 n. 7, p. article no. e184278-
dc.identifier.issn2574-3805-
dc.identifier.urihttp://hdl.handle.net/10722/289144-
dc.description.abstractImportance: Although 13% to 20% of American adolescents experience a depressive episode annually, no scalable primary care model for adolescent depression prevention is currently available. Objective: To study whether competent adulthood transition with cognitive behavioral humanistic and interpersonal training (CATCH-IT) lowers the hazard for depression in at-risk adolescents identified in primary care, as compared with a general health education (HE) attention control. Design, Setting, and Participants: This multicenter, randomized clinical trial, a phase 3 single-blind study, compares CATCH-IT with HE. Participants were enrolled from 2012 to 2016 and assessed at 2, 6, 12, 18, and 24 months postrandomization in a primary care setting. Eligible adolescents were aged 13 to 18 years with subsyndromal depression and/or history of depression and no current depression diagnosis or treatment. Of 2250 adolescents screened for eligibility, 446 participants completed the baseline interview, and 369 were randomized into CATCH-IT (n = 193) and HE (n = 176). Interventions: The internet-based intervention, CATCH-IT, is a 20-module (15 adolescent modules and 5 parent modules) online psychoeducation course that includes a parent program, supported by 3 motivational interviews. Main Outcomes and Measures: Time to event for depressive episode; depressive symptoms at 6 months. Results: Of 369 participants (mean [SD] age, 15.4 [1.5] years; 251 women [68%]) included in this trial, 193 were randomized into CATCH-IT and 176 into HE. Among these participants, 28% had both a past episode and subsyndromal depression; 12% had a past episode only, 59% had subsyndromal depression only, and 1% had borderline subsyndromal depression. The outcome of time to event favored CATCH-IT but was not significant with intention-to-treat analyses (unadjusted hazard ratio [HR], 0.59; 95% CI, 0.27-1.29; P = .18; adjusted HR, 0.53; 95% CI, 0.23-1.23; P = .14). Adolescents with higher baseline Center for Epidemiologic Studies Depression scale (CES-D10) scores showed a significantly stronger effect of CATCH-IT on time to event relative to those with lower baseline scores (HR 0.82; 95% CI, 0.67-0.99; P = .04). For example, the hazard ratio for a CES-D10 score of 15 was 0.20 (95% CI, 0.05-0.77), compared with a hazard ratio of 1.44 (95% CI, 0.41-5.03) for a CES-D10 score of 5. In both CATCH-IT and HE groups, depression symptoms declined and functional scores increased. Conclusions and Relevance: For preventing depressive episodes CATCH-IT may be better than HE for at-risk adolescents with subsyndromal depression. Also CATCH-IT may be a scalable approach to prevent depressive episodes in adolescents in primary care.-
dc.languageeng-
dc.publisherAmerican Medical Association: JAMA Network Open. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen-
dc.relation.ispartofJAMA Network Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDepression-
dc.subjectCognitive Behavioral Therapy-
dc.subjectAdolescents at Risk-
dc.titleEffect of Internet-Based Cognitive Behavioral Humanistic and Interpersonal Training vs Internet-Based General Health Education on Adolescent Depression in Primary Care: A Randomized Clinical Trial-
dc.typeArticle-
dc.identifier.emailIp, P: patricip@hku.hk-
dc.identifier.authorityIp, P=rp01337-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1001/jamanetworkopen.2018.4278-
dc.identifier.pmid30533601-
dc.identifier.pmcidPMC6286074-
dc.identifier.scopuseid_2-s2.0-85067436456-
dc.identifier.hkuros316098-
dc.identifier.volume1-
dc.identifier.issue7-
dc.identifier.spagearticle no. e184278-
dc.identifier.epagearticle no. e184278-
dc.identifier.isiWOS:000452649500025-
dc.publisher.placeUnited States-
dc.identifier.issnl2574-3805-

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