Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program

• NCJ Number: 205349
• Journal: Child & Adolescent Psychiatry Volume: 43 Issue: 5 Dated: May 2004 Pages: 538-547
• Author(s): Sally Merry; Heather McDowell; Chris J. Wild; Julliet Bir; Rachel Cunliffe
• Date Published: May 2004
• Length: 10 pages
• Grant Number(s): 99/039
• Sponsoring Agency: New Zealand Health Research Council
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United States of America

Annotation

This New Zealand study used a placebo-controlled design to determine the effectiveness of a universal school-based depression prevention program.

Abstract

Participants were recruited from two different years in two schools in Auckland, New Zealand, with one school (school A) located in a lower socioeconomic urban area and the other school (school B) located in a middle-class rural district. The schools were selected based on their ethnic mix, almost purely Maori and Pakeha, as well as the numbers on their rolls. All students in the 10th year at school A and the 9th year in school B were invited to participate in the program. A total of 399 students ages 13 to 15 at both schools were randomized to intervention (RAP-Kiwi program) and placebo programs operated by teachers. RAP-Kiwi was an 11-session program derived from cognitive-behavioral therapy and principles of interpersonal therapy that have proven effective in a cohort study that compared program intervention with no intervention. The placebo program was similar, but with cognitive components removed. Outcomes were measured with self-rated depression scales, the Reynolds Adolescent Depression Scale (RADS), and the Beck Depression Inventory II (BDI-II). Follow-up encompassed 18 months. The testing found that immediately after the intervention, depression scores were reduced significantly more by RAP-Kiwi than by the placebo program. Categorical analysis confirmed significant clinical benefits with an absolute risk reduction of 3 percent. Group differences in depression scores averaged across the 18-month follow-up were significant on RADS but not on BDI-II. Retention rates were 91 percent at 6 months and 72 percent at 18 months. This study concludes that the RAP-Kiwi program is a potentially effective public health intervention for depression in school-age children. Future research should confirm the program's effectiveness by measuring episodes of depressive illness and broader measures of adjustment. 32 tables, 2 figures, and 34 references