Is the Thoughts and Health programme feasible in the context of Swedish schools? A quasi-experimental controlled trial study protocol

Carl Wikberg, Pia Augustsson, Gudny Sveinsdottir, W Edward Craighead, Erikur Örn Arnarson, Ina Marteinsdottir, Josefine L Lilja, Carl Wikberg, Pia Augustsson, Gudny Sveinsdottir, W Edward Craighead, Erikur Örn Arnarson, Ina Marteinsdottir, Josefine L Lilja

Abstract

Introduction: Clinical depression is a substantial problem among adolescents, increasing significantly at about age 15 years. It causes impairment in social, academic and familial relationships, as well as ongoing cognitive and emotional difficulties for the individual. A study in Iceland demonstrated that a cognitive-behavioural, developmentally based intervention programme, 'Thoughts and Health', prevented initial episodes of depression and/or dysthymia (DYS) (major depressive disorder/DYS) in adolescents for up to 12 months following completion of the programme. We would like to test the feasibility of implementing the Icelandic method in a Swedish context and to evaluate the long-term effects of such a programme.

Methods and analysis: A quasi-experimental controlled design, combined with qualitative and quantitative methods, will be used to address the research questions.In this study, 617 children aged ~14 years will be screened for depression, and those "at risk" for development of clinical depression will be offered a 12 week course, 'Thoughts and Health'. This course aims to prevent first depression in adolescents. A comparable group of children will function as controls.Depending on the type of variable, baseline comparisons between the two groups of relevant initial measures will be evaluated with t-tests or χ2 analyses. The effects of the programme on the development of clinical levels of depression will be evaluated using the follow-up data of 6, 12 and 18 months. Index parental depression at baseline will be tested as a moderator in the evaluation of the effects of the prevention programme.

Ethics and dissemination: This study is approved by the Swedish Ethical Review Board (reference number 2019-03347) in Gothenburg.We plan to disseminate the knowledge gained from this study by publishing our results in peer-reviewed scientific journals and other scholarly outlets.

Trial registration number: NCT04128644; Pre-results.

Keywords: child & adolescent psychiatry; depression & mood disorders; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flowchart over the Thoughts and Health study.

References

    1. Hankin BL, Abramson LY, Moffitt TE, et al. . Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 1998;107:128–40. 10.1037/0021-843X.107.1.128
    1. Lewinsohn PM, Rohde P, Klein DN, et al. . Natural course of adolescent major depressive disorder: I. continuity into young adulthood. J Am Acad Child Adolesc Psychiatry 1999;38:56–63. 10.1097/00004583-199901000-00020
    1. Arnarson EO, Craighead WE. Prevention of depression among Icelandic adolescents. Behav Res Ther 2009;47:577–85. 10.1016/j.brat.2009.03.011
    1. Arnarson EO, Craighead WE. Prevention of depression among Icelandic adolescents: a 12-month follow-up. Behav Res Ther 2011;49:170–4. 10.1016/j.brat.2010.12.008
    1. Services S beredning för medicinsk och social utvärdering (SBU), SA for HTA and A of S . Program för att förebygga psykisk ohälsa hos barn. SBU 2010, 2010. Available: [Accessed 3 Feb 2020].
    1. Garber J, Clarke GN, Weersing VR, et al. . Prevention of depression in at-risk adolescents: a randomized controlled trial. JAMA 2009;301:2215–24. 10.1001/jama.2009.788
    1. Stice E, Rohde P, Seeley JR, et al. . Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: a randomized efficacy trial. J Consult Clin Psychol 2008;76:595–606. 10.1037/a0012645
    1. Clarke GN, Hawkins W, Murphy M, et al. . Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. J Am Acad Child Adolesc Psychiatry 1995;34:312–21. 10.1097/00004583-199503000-00016
    1. Erikson EH. Identity, youth and crisis. New York: WW Norton Company, 1968.
    1. Gillham JE, Hamilton J, Freres DR, et al. . Preventing depression among early adolescents in the primary care setting: a randomized controlled study of the Penn Resiliency program. J Abnorm Child Psychol 2006;34:195–211. 10.1007/s10802-005-9014-7
    1. Seligman MEP, Schulman P, Tryon AM. Group prevention of depression and anxiety symptoms. Behav Res Ther 2007;45:1111–26. 10.1016/j.brat.2006.09.010
    1. Stice E, Burton E, Bearman SK, et al. . Randomized trial of a brief depression prevention program: an elusive search for a psychosocial placebo control condition. Behav Res Ther 2007;45:863–76. 10.1016/j.brat.2006.08.008
    1. Horowitz JL, Garber J. The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psychol 2006;74:401–15. 10.1037/0022-006X.74.3.401
    1. Merry S, McDowell H, Hetrick S, et al. . Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database Syst Rev 2004:CD003380. 10.1002/14651858.CD003380.pub2
    1. Roberts CM, Kane R, Bishop B, et al. . The prevention of anxiety and depression in children from disadvantaged schools. Behav Res Ther 2010;48:68–73. 10.1016/j.brat.2009.09.002
    1. Sawyer MG, Pfeiffer S, Spence SH, et al. . School-Based prevention of depression: a randomised controlled study of the beyondblue schools research initiative. J Child Psychol Psychiatry 2010;51:199–209. 10.1111/j.1469-7610.2009.02136.x
    1. Klein DN, Glenn CR, Kosty DB, et al. . Predictors of first lifetime onset of major depressive disorder in young adulthood. J Abnorm Psychol 2013;122:1–6. 10.1037/a0029567
    1. Chan A-W, Tetzlaff JM, Altman DG, et al. . SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200–7. 10.7326/0003-4819-158-3-201302050-00583
    1. Ivarsson T, Svalander P, Litlere O. The children's depression inventory (CDI) as measure of depression in Swedish adolescents. A normative study. Nord J Psychiatry 2006;60:220–6. 10.1080/08039480600636395
    1. Sheehan DV, Sheehan KH, Shytle RD, et al. . Reliability and validity of the mini international neuropsychiatric interview for children and adolescents (MINI-KID). J Clin Psychiatry 2010;71:313–26. 10.4088/JCP.09m05305whi
    1. Chorpita BF, Moffitt CE, Gray J. Psychometric properties of the revised child anxiety and depression scale in a clinical sample. Behav Res Ther 2005;43:309–22. 10.1016/j.brat.2004.02.004
    1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC, 2013.
    1. Shaffer D, Gould MS, Brasic J, et al. . A children's global assessment scale (CGAS). Arch Gen Psychiatry 1983;40:1228–31. 10.1001/archpsyc.1983.01790100074010
    1. Mundt JC, Marks IM, Shear MK, et al. . The work and social adjustment scale: a simple measure of impairment in functioning. Br J Psychiatry 2002;180:461–4. 10.1192/bjp.180.5.461
    1. Keyes CLM. Atlanta: brief description of the mental health continuum short form (MHC-SF), 2009. Available:
    1. Keyes CLM, Wissing M, Potgieter JP, et al. . Evaluation of the mental health continuum-short form (MHC-SF) in setswana-speaking South Africans. Clin Psychol Psychother 2008;15:181–92. 10.1002/cpp.572
    1. Keyes CLM. The Subjective Well-Being of America’s Youth: Toward a Comprehensive Assessment. Adolescent & Family Health 2006;4:3–11.
    1. Lamers SMA, Glas CAW, Westerhof GJ. Longitudinal evaluation of the mental health continuum-short form (MHC-SF): measurement invariance across demographics, physical illness, and mental illness. Eur J Psychol Assess 2012;28:290–6. 10.1027/1015-5759/a000109

Source: PubMed

3
Předplatit