a Department of Child and Adolescent Psychiatry and Behavioral Sciences , Children's Hospital of Philadelphia.
b PolicyLab , Children's Hospital of Philadelphia.
J Clin Child Adolesc Psychol. 2019;48(sup1):S362-S370. doi: 10.1080/15374416.2018.1479965. Epub 2018 Jul 6.
Adolescence represents a vulnerable developmental period for depression and an opportune time for prevention efforts. In this study, 186 adolescents with elevated depressive symptoms (M age = 14.01, SD = 1.22; 66.7% female; 32.2% racial minority) were randomized to receive either Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST; n = 95) delivered by research clinicians or group counseling (GC; n = 91) delivered by school counselors. We previously reported the short-term outcomes of this school-based randomized controlled trial: IPT-AST youth experienced significantly greater improvements in depressive symptoms and overall functioning through 6-month follow-up. Here, we present the long-term outcomes through 24 months postintervention. We examined differences in rates of change in depressive symptoms and overall functioning and differences in rates of depression diagnoses. Youth in both conditions showed significant improvements in depressive symptoms and overall functioning from baseline to 24-month follow-up, demonstrating the efficacy of school-based depression prevention programs. However, the two groups did not differ in overall rates of change or in rates of depression diagnoses from baseline to 24-month follow-up. Although IPT-AST demonstrated advantages over GC in the short term, these effects dissipated over long-term follow-up. Specifically, from 6- to 24-month follow-up, GC youth showed continued decreases in depressive symptoms, whereas IPT-AST youth showed a nonsignificant increase in symptoms. GC youth remained relatively stable in overall functioning, whereas IPT-AST youth experienced a small but statistically significant worsening in functioning. This study highlights the potential of school-based depression prevention efforts and the need for further research.
青春期是抑郁症的脆弱发展阶段，也是预防工作的适宜时机。在这项研究中，186 名有抑郁症状升高的青少年（M 年龄=14.01，SD=1.22；66.7%为女性；32.2%为少数民族）被随机分配接受研究临床医生提供的人际心理治疗-青少年技能培训（IPT-AST；n=95）或学校辅导员提供的团体咨询（GC；n=91）。我们之前报告了这项基于学校的随机对照试验的短期结果：IPT-AST 青少年在 6 个月随访时经历了更显著的抑郁症状和整体功能改善。在这里，我们介绍了干预后 24 个月的长期结果。我们检查了抑郁症状和整体功能变化率的差异以及抑郁诊断率的差异。两种情况下的青少年在从基线到 24 个月随访时，抑郁症状和整体功能都有显著改善，这表明基于学校的抑郁预防计划是有效的。然而，两组在从基线到 24 个月随访时的总体变化率或抑郁诊断率方面没有差异。虽然 IPT-AST 在短期内优于 GC，但这些效果在长期随访中消失了。具体来说，从 6 个月到 24 个月随访，GC 青少年的抑郁症状继续减少，而 IPT-AST 青少年的症状没有显著增加。GC 青少年的整体功能保持相对稳定，而 IPT-AST 青少年的功能略有但统计学上显著恶化。这项研究强调了基于学校的抑郁预防工作的潜力和进一步研究的必要性。
