Depression Prevention Programs for Adolescents

(P2P Trial)

Overseen By Matthew Lowther, MSW, MPH

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Must not be taking: Antidepressants, Antianxiety

Disqualifiers: Major depression, Schizophrenia, Bipolar, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 8 sessions

636 Participants Needed

Trial Summary

What is the purpose of this trial?

PATH (Promoting AdolescenT Health) 2 Purpose is a two-arm comparative effectiveness research trial to that will evaluate the ability of the interventions, Competent Adulthood Transition with Cognitive-behavioral \& Interpersonal Training (CATCH-IT) and Teens Achieving Mastery over Stress (TEAMS), to intervene early to prevent depressive illness and potentially other common mental health disorders. Using cluster randomization, 564 participants eligible for the study will be offered one of two different depression prevention programs in multiple sites in Chicagoland, Rockford, Illinois; Dixon, Illinois; and Louisville, Kentucky. In response to the Coronavirus Disease 2019 (COVID-19) pandemic, we will employ a public health media campaign to recruit a second cohort of 100 adolescents state-wide in Illinois, Kentucky, and Massachusetts individually randomized to either intervention. The study will also assess teens', parents' and providers' experiences with each intervention approach. Finally, we will examine the impact of the COVID-19 pandemic on adolescents at-risk for depression who are enrolled in our study.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you have been using medication therapy for depression, anxiety, or other internalizing disorders for less than 3 months.

What data supports the effectiveness of the treatment CATCH-IT for preventing depression in adolescents?

Research shows that cognitive behavioral therapy (CBT), a component of CATCH-IT, can lead to faster recovery from depression in adolescents compared to other treatments. Additionally, interpersonal psychotherapy, another component, has been effective in reducing depressive symptoms and improving overall functioning in adolescents. ^{1 2 3 4 5}

Is the Depression Prevention Program for Adolescents safe?

The studies reviewed did not report any specific safety concerns for the depression prevention programs, including Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) and Behavioral Activation (BA), suggesting they are generally safe for adolescents. ^{4 6 7 8 9}

How is the CATCH-IT, TEAMS treatment different from other treatments for adolescent depression?

CATCH-IT, TEAMS is unique because it combines cognitive-behavioral, humanistic, and interpersonal training to prevent depression in adolescents, focusing on building skills for a successful transition to adulthood. Unlike standard treatments, it emphasizes prevention and skill-building rather than just treating existing symptoms. ^{1 3 8 10 11}

Research Team

Tracy RG Gladstone, PhD

Principal Investigator

Wellesley College, Wellesley Centers for Women

Benjamin W Van Voorhees, MD, MPH

Principal Investigator

University of Illinois at Chicago, School of Medicine

Eligibility Criteria

This trial is for teens aged 13-19 with a history of depression but not currently depressed, showing elevated depressive symptoms without severe drug/alcohol abuse or high-risk psychiatric conditions. They shouldn't be on recent medication for mood disorders or engaged in cognitive therapy.

Inclusion Criteria

I am between 13 and 19 years old.

Adolescent must be experiencing an elevated level of depressive symptoms (Patient Health Questionnaire-9 Score = 5-18)

I am a teenager who has had depression in the past but not now.

Exclusion Criteria

Did not complete phone assessment with MINI Kid

I am not interested in participating in the trial anymore.

I am not comfortable being audio recorded during group sessions.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the CATCH-IT or TEAMS intervention for depression prevention

8 sessions

Sessions conducted online or in-person

Follow-up

Participants are monitored for safety and effectiveness after treatment

18 months

Assessments at 2, 6, 12, and 18 months

Open-label extension (optional)

Participants may continue to engage with the intervention for further support

Long-term

Treatment Details

Interventions

• CATCH-IT
• TEAMS

Trial Overview The PATH 2 Purpose study compares two programs: CATCH-IT and TEAMS, aimed at preventing depression among adolescents. Participants are randomly assigned to one of the interventions across various locations, assessing their effectiveness and experiences during COVID-19.

Participant Groups

Group I: CATCH-IT Experimental Treatment 1 Intervention

Competent Adulthood Transition with Cognitive-behavioral \& Interpersonal Training (CATCH-IT) is an internet-based depression prevention program that targets decreasing modifiable risk factors while enhancing protective factors in at-risk adolescents, and that includes a parent program. It has been shown to be safe, feasible, and efficacious.

Group II: TEAMS Active Control 1 Intervention

Teens Achieving Mastery over Stress (TEAMS) is an 8-session group depression prevention program teaching teens how to deal with stress and negative moods, and ways to manage low mood based on cognitive-behavioral therapy (CBT) principles and strategies. Efficacy has been demonstrated by several trials over time.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

Wake Forest University Health Sciences

Collaborator

Trials

1,432

Recruited

2,506,000+

Brown University

Collaborator

Trials

480

Recruited

724,000+

Mile Square Health Center

Collaborator

Trials

2

Recruited

1,000+

University of Illinois College of Medicine Rockford

Collaborator

Trials

2

Recruited

680+

Wellesley College

Collaborator

Trials

6

Recruited

3,100+

Advocate Health Care

Collaborator

Trials

57

Recruited

1,412,000+

University of Louisville

Collaborator

Trials

353

Recruited

76,400+

Patient-Centered Outcomes Research Institute

Collaborator

Trials

592

Recruited

27,110,000+

Katherine Shaw Bethea Hospital

Collaborator

Trials

1

Recruited

640+

Findings from Research

The family-based interpersonal psychotherapy (FB-IPT) showed high treatment compliance (88%) and led to significant reductions in depressive and anxiety symptoms among 16 preadolescents aged 9-12, indicating its feasibility and acceptability as a treatment option.

Preadolescents receiving FB-IPT alone experienced similar improvements in depressive symptoms and global functioning as those who also received antidepressant medication, suggesting that FB-IPT can be effective on its own.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-based interpersonal psychotherapy for depressed preadolescents: an open-treatment trial. Dietz, LJ., Mufson, L., Irvine, H., et al.[2021]

In a study involving 88 clinically depressed adolescents, manualized cognitive behavioral therapy (CBT) did not show superior effectiveness compared to Treatment As Usual (TAU) in reducing depressive symptoms, with both treatments yielding similar outcomes.

At post-treatment, 41.6% of adolescents receiving CBT and 31.8% receiving TAU were below the clinical cut-off for depressive symptoms, indicating that while both treatments were effective, CBT needs further refinement to enhance its efficacy in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and moderators of individual cognitive behavioral therapy versus treatment as usual in clinically depressed adolescents: a randomized controlled trial. Stikkelbroek, Y., Vink, G., Nauta, MH., et al.[2021]

In a study of 114 depressed adolescents from a juvenile justice center, factors such as earlier onset of major depressive disorder (MDD), attention-deficit/hyperactivity disorder, and low family cohesion were identified as predictors of recovery time over a 1-year follow-up.

Cognitive Behavioral Therapy (CBT) led to faster recovery compared to a life skills-tutoring control, particularly for White adolescents with recurrent MDD and good coping skills, highlighting the importance of tailored treatment approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predicting time to recovery among depressed adolescents treated in two psychosocial group interventions. Rohde, P., Seeley, JR., Kaufman, NK., et al.[2019]

The 'Training for Awareness, Resilience and Action' (TARA) program is a novel group-treatment designed specifically for adolescents and young adults with depression, targeting mechanisms identified through neuroscientific research, and has shown preliminary efficacy in treating this age group.

This study will be the first randomized controlled trial (RCT) to compare TARA with standard treatments for major and persistent depressive disorders in patients aged 15-22, using a variety of outcome measures to comprehensively evaluate its effectiveness over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Training for Awareness Resilience and Action Online Compared to Standard Treatment for Adolescents and Young Adults With Depression: Study Protocol and Analysis Plan for a Pragmatic, Multi-Center Randomized Controlled Superiority Trial. Ekbäck, E., Granåsen, G., Svärling, R., et al.[2021]

Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for major depressive disorders in adolescents, with a meta-analysis revealing an overall effect size of 1.27 and 63% of patients experiencing clinically significant improvement after treatment.

The article aims to summarize various psychosocial interventions for depressed adolescents, making it easier for clinicians to access and utilize these resources in their practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychosocial treatments for adolescent depression. Lewinsohn, PM., Clarke, GN.[2019]

References

1. Australia pubmed.ncbi.nlm.nih.gov

Family-based interpersonal psychotherapy for depressed preadolescents: an open-treatment trial. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Long-Term Effects from a School-Based Trial Comparing Interpersonal Psychotherapy-Adolescent Skills Training to Group Counseling. [2020]

3. England pubmed.ncbi.nlm.nih.gov

The Depression Prevention Initiative: Mediators of Interpersonal Psychotherapy-Adolescent Skills Training. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness and moderators of individual cognitive behavioral therapy versus treatment as usual in clinically depressed adolescents: a randomized controlled trial. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Predicting time to recovery among depressed adolescents treated in two psychosocial group interventions. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Depression Prevention in Pediatric Primary Care: Implementation and Outcomes of Interpersonal Psychotherapy-Adolescent Skills Training. [2023]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Training for Awareness Resilience and Action Online Compared to Standard Treatment for Adolescents and Young Adults With Depression: Study Protocol and Analysis Plan for a Pragmatic, Multi-Center Randomized Controlled Superiority Trial. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

A Randomized Depression Prevention Trial Comparing Interpersonal Psychotherapy--Adolescent Skills Training to Group Counseling in Schools. [2018]

9. England pubmed.ncbi.nlm.nih.gov

The Adolescent Behavioral Activation Program: Adapting Behavioral Activation as a Treatment for Depression in Adolescence. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: effects at 1- and 2-year follow-up. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Psychosocial treatments for adolescent depression. [2019]