ERIC Number: EJ696234
Record Type: Journal
Publication Date: 2004-May-1
A Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program.
Merry, Sally; McDowell, Heather; Wild, Chris J.; Bir, Julliet; Cunliffe, Rachel
Journal of the American Academy of Child and Adolescent Psychiatry, v43 n5 p538 May 2004
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 square], 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. J. Am. Acad. Child Adolesc. Psychiatry, 2004;43(5):538-547. Key Words: depression, prevention, adolescent, randomized controlled trial.
Descriptors: Program Effectiveness, Geometric Concepts, Statistical Analysis, Psychiatry, Prevention, Intervention, Risk, Public Health, Depression (Psychology)
Lippincott Williams & Wilkins, P.O. Box 1620, Hagerstown, MD 21741. Tel: 800-638-3030 (Toll Free); Fax: 301-223-2400.
Publication Type: Journal Articles
Education Level: N/A
Authoring Institution: N/A
Identifiers - Assessments and Surveys: Beck Depression Inventory