An Internet program helps to reduce depressive symptoms and prevent episodes of clinical depression in adolescent patients at risk, reports a study in the February issue of the Journal of Developmental & Behavioral Pediatrics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

Called “Project CATCH-IT,” the program is an engaging and effective new alternative for managing depression in teens, according to a study led by Dr. Benjamin W. Van Voorhees of University of Chicago. “[A]n Internet-based program may offer a low-cost way to implement depression prevention in community settings,” Dr. Van Voorhees and colleagues write. This study was sponsored by the National Alliance for Research on Schizophrenia and Depression (NARSAD), the Robert Wood Johnson Foundation, and the National Institute of Mental Health.

Project CATCH-IT Teaches Strategies to Head Off Depression
The researchers tested the benefits of Project CATCH-IT in 83 adolescent and young adult patients considered at risk for depression—all had relatively mild depressive symptoms lasting longer than a few weeks. Patients were randomly assigned to undergo a brief discussion regarding depression with their doctor, or to a longer “motivational interview.”

Both groups were then given the Internet address for Project CATCH-IT, which the researchers describe as an “Internet-based behavior change/resiliency building intervention.” Based on proven therapies such as cognitive-behavioral therapy, behavioral activation, and interpersonal therapy, Project CATCH-IT is designed to reduce thoughts, behaviors, and relations that increase vulnerability to depression. At the same time, the program builds skills that reduce the risk of depression and promote a successful transition to adulthood.

Program Helps Improve Mood, Prevent Episodes of Depression
Most of the teens in the study used the Project CATCH-IT website, including 90 percent of those assigned to the longer motivational interview with their doctor. Most importantly, Project CATCH-IT was effective in preventing episodes of clinical depression. Based on a standard score, the percentage of patients with “clinically significant” depression decreased from about 50 percent at the start of the study to no more than 15 percent at three months’ follow-up.

The researchers hypothesized that teens receiving the longer motivational interview would do better. However, overall depression scores were similar to those of patients assigned to the brief interview. Teens receiving the motivational interview did have better outcomes in some areas, including fewer thoughts of self-harm or hopelessness and were much less likely to be diagnosed with a depressive episode during the follow-up period. Patients assigned to the motivational interview spent more time using the site, which may have led to the additional improvements. Similarly, perhaps the teens who received the motivational interview were more motivated to take change behaviors to prevent a depressive episode.

New approaches to preventing depression are needed, and the primary care doctor’s office is an important location for the identification and treatment of depression in teens. Previous studies have reported success with Internet-based programs for depression. “However, few similar interventions have been developed for adolescents and they have been limited by low levels of participation,” according to the authors.

The new results show that teens with depressive symptoms will use Project CATCH-IT at their doctor’s recommendation, and that the program may reduce the risk of depression. “Nearly half the sample was asymptomatic at six weeks, prevalence of clinically significant depressed mood dropped by more than half, and the incidence of any depressive disorder remained low,” Dr. Van Voorhees and colleagues write. They call for further research, including the development of “more engaging Internet models” and randomized trials comparing Internet-based interventions with standard treatment for depression in adolescents.

About the Journal of Developmental & Behavioral Pediatrics
Written for physicians, clinicians, psychologists and researchers, each bimonthly issue of the Journal of Developmental & Behavioral Pediatrics is devoted entirely to the developmental and psychosocial aspects of pediatric health care. Each issue features original articles, case reports, challenging cases and reviews that help professionals across disciplines stay current with the latest information in the field. Relevant areas covered include learning disorders, developmental disabilities, and emotional, behavioral, and psychosomatic problems. Journal of Developmental & Behavioral Pediatrics is the official journal of the Society for Developmental and Behavioral Pediatrics.

About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

Wolters Kluwer Health is a division of Wolters Kluwer, a leading global information services and publishing company with annual revenues (2007) of €3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,500 people worldwide.

Source: Wolters Kluwer Health: Lippincott Williams & Wilkins