Indicated preventive interventions for depression in children and adolescents: A meta-analysis and meta-regression

Ssegonja, Richard; Nystrand, Camilla; Feldman, Inna; Sarkadi, Anna; Langenskiöld, Sophie; Jönsson, Ulf

doi:10.1016/j.ypmed.2018.09.021

Cited by 33 publications

(12 citation statements)

References 67 publications

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“…Adolescents with severe depression are at increased risk of self-harm and suicidal ideation. However, the trajectory to severe mental illness can be interrupted or even reversed if children are identified early in the disease course when intervention is most effective (Ssegonja et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Trends in the utilization of a peer‐supported youth hotline

Kerner

Eskin

Tseng

et al. 2020

Child Adoles Ment Health

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Background Peer‐supported youth hotlines have been in operation for many years but studies on the acceptance of this hotline model or on the demographics of the callers are lacking. This study was performed to examine the utilization of a metropolitan peer‐supported youth hotline between 2010 and 2016. Method The change in demographics, contact channels, and the reasons for contact were analyzed with standard linear regression analysis in 67,478 contacts over 7 years. Results The data revealed a significant increase in hotline utilization from 8008 annual contacts in 2010 to 12,409 contacts in 2016 (p = .03). The majority of contacts were made by 15‐year‐old and 16‐year‐old girls, but contacts by children aged 13 years old and younger have also increased significantly over the years (p = .003). In 2016, anxiety and stress were among the leading reasons for contact (20.14%), followed by sadness and depression (17.21%), suicidal ideation (14.18%), and self‐harm (8.15%). Recommendations for follow‐up with outside mental health resources were made in 56.22% of contacts. More than 60% of contacts had found information about the hotline on the Internet. More than 30% used text messaging to reach out to the hotline. Conclusions Our data indicate that adolescents increasingly utilize a peer‐supported youth hotline to get help for mental health concerns. Therefore, it should be explored whether this hotline model could also be used for prevention and early intervention. Key Practitioner Message Peer‐supported youth hotlines are well accepted and frequently utilized by adolescents to get help for mental health issues. Our data indicate that peer‐supported youth hotlines could be utilized to identify youth at risk for depression and suicide. Further research should evaluate whether peer‐supported youth hotlines could serve in the prevention and in early mental health intervention, and how they could be effectively linked to other mental health resources in the community.

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Section: Discussionmentioning

confidence: 99%

Trends in the utilization of a peer‐supported youth hotline

Kerner

Eskin

Tseng

et al. 2020

Child Adoles Ment Health

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“…In addition, a substantial proportion of depressed adolescents do not respond to available evidence-based pharmacological and psychological treatments [5], or present with recurrent depressive episodes [6]. Similarly discouraging, the effect of indicated prevention seems to wear off over time [7]. There is therefore the need to identify relevant factors contributing to the persistence and treatment failure of adolescent 1 3 depression, in order to inform potential targets for clinical intervention.…”

Section: Introductionmentioning

confidence: 99%

Parent–youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort

Alaie

Låftman

Jönsson

et al. 2019

Eur Child Adolesc Psychiatry

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Experiencing conflictual relations with one's parents while growing up has been linked to onset, recurrence, and worse treatment outcome of adolescent depression. While this suggests that significant problems in the parent-youth relationship make depressive disorders more relentless, it is not clear whether this effect lasts into adulthood. Our aim was to examine if major and minor conflict with parents while growing up predicts depression in adulthood in youth with and without a history of depression. We utilized data from the Uppsala Longitudinal Adolescent Depression Study. This community-based cohort was assessed with structured diagnostic interviews both at age 16-17 and at follow-up 15 years later. The analyses included 382 individuals (227 with a history of child or adolescent depression; 155 peers without such a history). Binary logistic regression was used, adjusting for sex, disruptive behavior disorders, and additional family-related adversities. Among individuals with adolescent depression, major conflict with parents was strongly associated with adult depression (adjusted OR 2.28, 95% CI 1.07-4.87). While major conflict with parents was rare among non-depressed controls, a non-significant association of similar magnitude was still observed. Minor conflict, on the other hand, was not significantly associated with adult depression. Overall, conflict with parents did not predict adult anxiety disorders, substance use, suicidal behavior, somatoform disorders, or psychotic disorders. In conclusion, major parent-youth conflict during upbringing seems to be linked with an increased risk of depression in adulthood. These findings underscore the need to consider contextual/familial factors in the prevention and clinical management of early-life depression.

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“…The symptom change seen with the four modules together (called STARr-training) seems comparable to pattern seen in conventional CBT. A recent meta-analysis, that compared protocolled CBT based group depression prevention programs for high risk adolescents to inactive controls (e.g., waitlist), showed a superior effect for protocolled CBT with small overall effect sizes at post-intervention and 12-month followup, but negligible overall effect sizes at 6-and >12month follow-up (Ssegonja et al, 2019). The pattern of change we observed appeared comparable, but cannot be compared directly as we investigated within-group effects and did not compare the sequences to an inactive control.…”

Section: Discussionmentioning

confidence: 99%

“…Meta-analyses have shown that indicated prevention programs based on Cognitive Behavioral Therapy (CBT) can reduce the levels of depressive symptoms and the incidence of depressive disorders among youth (e.g., Horowitz & Garber, 2006;Ssegonja et al, 2019). However, the effect sizes are modest.…”

mentioning

confidence: 99%

Relative Effectiveness of CBT-Components and Sequencing in Indicated Depression Prevention for Adolescents: A Cluster-Randomized Microtrial

Heuvel

Bodden

Smit

et al. 2021

Journal of Clinical Child & Adolescent Psychology

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Objective: Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. Method: We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69);(3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (M age = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. Results: None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. Conclusions: Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post-intervention or 6-month follow-up.

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Indicated preventive interventions for depression in children and adolescents: A meta-analysis and meta-regression

Cited by 33 publications

References 67 publications

Trends in the utilization of a peer‐supported youth hotline

Trends in the utilization of a peer‐supported youth hotline

Parent–youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort

Relative Effectiveness of CBT-Components and Sequencing in Indicated Depression Prevention for Adolescents: A Cluster-Randomized Microtrial

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