Thoughts and Health - Preventing Depression in Adolescents

Study Overview
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Brief Summary
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This study aims to test the feasibility of implementing an Icelandic cognitive-behavioral program designed to prevent depression, called Thoughts and Health in a Swedish school setting. The investigators will also evaluate whether implementation of the program has an impact on the participating students, regarding both their mental health and their success in finishing junior high school with passing grades.

Detailed Description
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Clinical depression is a crucial problem among adolescents. In eighth grade more than half of all students experience headaches, stomach pain, stress, feeling down, and difficulties sleeping. Adolescents affected by depression at a young age are at greater risk of experiencing depressive symptoms as adults, with serious impacts on their quality of life and ability to work. Recent reports from the National Board of Health and Welfare have shown that depression is increasing among adolescents and there is now focus on implementing practice-oriented preventative programs for youth. Studies by members of our research team have shown that a cognitive-behavioral, developmentally-based intervention program, called Thoughts and Health, prevented initial episodes of depression and/or dysthymia in adolescents for up to 12 months after program completion. This study aims to test the feasibility of implementing that program in a Swedish school setting, while also collecting and analyzing preliminary results regarding the potential impact of the program on number of students developing depressive symptoms and the number passing junior high school with full grades. This is an intervention study with a control group. Students from two Swedish junior high schools will be identified as at-risk and invited to participate in the program (n=40), while students from two other schools will act as controls (n=40). All participating students will be followed from study start (baseline) and 1, 6, 12, and 18 months after program completion. Results will include quantitative clinical measures, qualitative focus group discussions, and students' final grades. Two courses of the program will be run over two school years. This study involves close collaboration between academia, primary care, and the community. This is to our knowledge the first study in Sweden that employs a longitudinal design to evaluate the effects of a school program aimed at preventing depression in adolescents.

Official Title
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Thoughts and Health - Preventing Depression in Adolescents

Conditions
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Depression, Adolescent Development, Mental Disorder, Child

Intervention / Treatment
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* Behavioral: Thoughts & health
* Other: Treatment as Usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eight grader (school) Completed Childrens Depression Inventory (CDI) screening Able to understand Swedish both orally and written to a level that he/she can complete forms and questionnaires by themselves Exclusion Criteria: Current or past depression Unable to function in a group session Current psychotherapeutic treatment Past or current suicidal thoughts or attempts

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Standard of care+Thoughts & health<br>12 sessions of Thoughts & Health. Baseline questionnaires and follow up assessments | Behavioral: Thoughts & health<br>* 12 sessions of Thoughts & Health. Baseline questionaires and follow up assessments<br>Other: Treatment as Usual<br>* Baseline questionnaires and follow up assessments, intervention as usual, Student Health<br>|
| Other: Standard of care<br>Baseline questionnaires and follow up assessments, intervention as usual Student Health | Other: Treatment as Usual<br>* Baseline questionnaires and follow up assessments, intervention as usual, Student Health<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depressive episode | Number of participants that have scores that indicate a depressive episode. Questionnaire CDI (Children Depression Inventory), CDI has 27 items scores, each item range from 0-3, above the 90th percentile indicate depressive problems, 90th percentile indicate depressive episode. | 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complete grades | Measures if participants have complete grades from ninth grade when finishing school. Will be collected through public school registers. | 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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depression, prevention, school