Reducing Health Risk Behaviors and Improving Depression in Adolescents: A Randomized Controlled Trial in Primary Care Clinics

Bai, Sunhye; Zeledon, Luis R; D’Amico, Elizabeth J.; Shoptaw, Steven; Avina, Claudia; LaBorde, Anne P.; Anderson, Martin; Fitzpatrick, Olivia; Asarnow, Joan Rosenbaum

doi:10.1093/jpepsy/jsy048

Cited by 15 publications

(18 citation statements)

References 38 publications

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“…The present report also revealed that adolescents who were currently smoking had greater odds of depression compared to those who did not smoke. This finding is in line with previous reports [ 34 – 35 ] and also consistent with a randomized controlled trial [ 36 ]. However, the present study found no statistically significant associations between depression among adolescent students and father’s education and occupation, mother’s education and occupation, living with parents, family size, and school grade.…”

Section: Discussionsupporting

confidence: 94%

Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study

et al. 2021

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Background Common mental disorders in early life represent a major concern as they become more complex and intense with transition into adolescence. Despite global recognition of the significance of adolescent mental health, it remains a neglected area in research and health policy in Bangladesh. This study aimed to investigate the prevalence and factors associated with depression and anxiety among school going adolescents in Bangladesh. Methods A cross-sectional survey was conducted among 563 students aged 13–18 years at selected schools (secondary and higher secondary) in Dhaka City. After providing written informed consent, participants completed a survey examining socio-demographic variables, along with the PHQ-9 and GAD-7 scales. Logistic regression was used to examine associations between variables under examination. Results The prevalence rates of moderate to severe levels of depression and anxiety were 26.5% and 18.1%, respectively. Based on multivariable analyses, unsatisfactory sleep (AOR = 3.17; 95% CI = 1.81–5.53, p < .001), cigarette smoking (AOR = 2.00; 95% CI = 1.01–3.97, p = .048), and anxiety (AOR = 10.47; 95% CI = 6.11–17.95, p < .001) were associated with depression. Anxiety was associated with being 15–16 years (AOR = 2.66; 95% CI = 1.18–6.00, p = .018), not having good perceived relationships with friends (AOR = 2.10; 95% CI = 1.24–3.56, p = .006) and depression (AOR = 10.22; 95% CI = 6.01–17.38, p < .001). Conclusions Depression and anxiety were prevalent among school going adolescents in Bangladesh. The findings suggest epidemiological data can direct policy-level decisions regarding evaluation, prevention, and intervention of mental health conditions among school going adolescents in Bangladesh.

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Section: Discussionsupporting

confidence: 94%

Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study

et al. 2021

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“…Nevertheless, our findings of a leveling off between weeks 16-52 and an attenuation of the acute treatment effect for depression call for caution in interpreting the initial FFT-CD advantage. Longer followup might have revealed stronger benefits (consistent with results on FFT for bipolar illness, Miklowitz et al, 2014) and is needed for evaluation of longerterm risks including depression-recurrence, SAs, and health-risk behaviors (Bai et al, 2018;Kovacs et al, 2016;Weissman et al, 1999). Study treatments were delivered within a rigorous efficacy trial with extensive therapist training and clinical monitoring, likely strengthening both safety and benefits.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of family‐focused treatment for child depression compared to individual psychotherapy: one‐year outcomes

Asarnow

Tompson

Klomhaus

et al. 2019

Child Psychology Psychiatry

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Objective: Childhood-onset depression is associated with increased risk of recurrent depression and high morbidity extending into adolescence and adulthood. This multisite randomized controlled trial evaluated two active psychosocial treatments for childhood depression: family-focused treatment for childhood depression (FFT-CD) and individual supportive psychotherapy (IP). Aims were to describe effects through 52 weeks postrandomization on measures of depression, functioning, nondepressive symptoms, and harm events. Methods: Children meeting criteria for depressive disorders (N = 134) were randomly assigned to 15 sessions of FFT-CD or IP and evaluated at mid-treatment for depressive symptoms and fully at roughly 16 weeks (after acute treatment), 32 weeks, and 52 weeks/one year. See clinicaltrials.gov: NCT01159041. Results: Analyses using generalized linear mixed models confirmed the previously reported FFT-CD advantage on rates of acute depression response (≥50% Children's Depression Rating Scale reduction). Improvements in depression and other outcomes were most rapid during the acute treatment period, and leveled off between weeks 16 and 52, with a corresponding attenuation of observed group differences, although both groups showed improved depression and functioning over 52 weeks. Survival analyses indicated that most children recovered from their index depressive episodes by week 52: estimated 76% FFT-CD, 77% IP. However, by the week 52 assessment, one FFT-CD child and six IP children had suffered recurrent depressive episodes. Four children attempted suicide, all in the IP group. Other indicators of possible harm were relatively evenly distributed across groups. Conclusions: Results indicate a quicker depression response in FFT-CD and hint at greater protection from recurrence and suicide attempts. However, outcomes were similar for both active treatments by week 52/one year. Although community care received after acute treatment may have influenced results, findings suggest the value of a more extended/chronic disease model that includes monitoring and guidance regarding optimal interventions when signs of depression-risk emerge. Key pointsChildhood-onset depressive disorders are associated with substantial morbidity and mortality. This is the first large multisite RCT to evaluate two active psychosocial treatment strategies for children ages 7-14 with depressive disorders.Results indicate a quicker depression response in family-focused treatment, compared to individual psychotherapy after roughly 16 weeks of acute treatment, and a hint of greater protection from recurrence and suicide attempts. However, outcomes were similar for both treatments by week 52/one year.Although community care received after acute treatment may have influenced results, findings suggest the value of an extended/chronic disease model that includes monitoring and clinical guidance regarding optimal interventions when signs of depression-risk emerge.

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“…Additionally, adolescents with depressive emotions are less willing to engage in physical activities such as participating in sports clubs or going to the gym [18]. However, research has also shown that the likelihood of adolescent depression occurrence can be lowered through education and cultivating health behaviors [19]. Health-promotion courses that were found to be effective in reducing the occurrence of adolescent depression include stress management courses, self-understanding courses, self-control courses, and interpersonal relationships courses [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Relationships between depression, health‑related behaviors, and internet addiction in female junior college students

Yang

Chen

et al. 2019

PLoS ONE

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Introduction Depressive emotions can lead to subsequent unhealthy behaviors such as Internet addiction, especially in female adolescents; therefore, studies that examine the relationships among depression, health‑related behaviors, and Internet addiction in female adolescents are warranted. Purpose To examine (1) the relationship between depression and health-related behaviors and (2) the relationship between depression and Internet addiction. Method A cross-sectional study design was adopted using a structured questionnaire to measure depression, health-related behaviors, and Internet addiction in female adolescents. The data were collected from students of a junior college in southern Taiwan using convenience sampling to select the participants. The questionnaire was divided into four sections: demographics, the Center for Epidemiologic Studies Depression Scale (CES-D), the Health Promoting Lifestyle Profile (HPLP), and the Internet Addiction Test (IAT). Results The final sample comprised 503 female junior college students, with the participants mainly aged between 15 to 22 years (mean age = 17.30 years, SD = 1.34). Regarding the HPLP scores, the overall score, nutrition subscale score, and self-actualization subscale score were significantly and negatively associated with the CES-D depression score ( p < 0.05–0.01). In other words, depression level was lower in students who exhibited more healthy behaviors, put more emphasis on dietary health, and had higher levels of self-admiration and confidence toward life. Regarding the IAT scores, the overall score and six domain scores were all positively associated ( p < 0.01) to the CES-D depression score. In other words, the higher an individual’s Internet addiction score was, the higher her depression level was. Conclusions The results confirmed the relationship between depression, health-related behaviors, and Internet addiction. The cultivation of health-related behaviors may help in lowering depressive symptoms. Teenagers with depression have higher risks of developing Internet addiction, and such addiction is likely to affect their daily functioning.

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Reducing Health Risk Behaviors and Improving Depression in Adolescents: A Randomized Controlled Trial in Primary Care Clinics

Cited by 15 publications

References 38 publications

Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study

Prevalence of depression, anxiety and associated factors among school going adolescents in Bangladesh: Findings from a cross-sectional study

Randomized controlled trial of family‐focused treatment for child depression compared to individual psychotherapy: one‐year outcomes

Relationships between depression, health‑related behaviors, and internet addiction in female junior college students

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