A cognitive-behavioral prevention program to prevent depressive symptoms for teens may still be effective years later, according to a new study.

“We have already shown that the intervention was more effective than usual care but it is surprising that we are still finding a difference between groups six years later,” said lead author Dr. David A. Brent of Pittsburgh Medical Center.

Over time, the teens in the therapy group were still at risk for depression but were functioning better at work and in their interpersonal lives as a result of having more depression free days, Brent told Reuters Health.

The researchers randomly divided 316 teens, with prior depressive episodes and with at least one parent having current or depressive episodes into 2 groups.

Teens in the cognitive-behavioral prevention program attended 8 weekly 90-minute group therapy sessions followed by 6 months of monthly sessions. The other group did not receive care other than what might have been initiated by their family members.

Some teens in each group did develop depression during the study period and over the six-year follow up period, but it was less common in the therapy group, the authors reported in JAMA Psychiatry.

“Even 6 years after the intervention,” the risk of depression was lower for adolescents who received cognitive-behavioral prevention therapy than for those who received usual care, said the authors.

“This preventive effect largely was driven by the significant difference in new onsets of depression during the first 9 months after enrollment,” they added, because after that point, the risk of new depressive episodes was similar in the 2 groups.

The therapy was most effective for kids whose parents were not depressed when the study began, the authors noted.

“Theoretically, cognitive-behavioral therapy works by changing children’s thinking patterns – so that they can challenge negative thoughts and not engage in the kinds of interpretations of events in their lives that lead to depression,” said Irwin Sandler, director of the Prevention Research Center at Arizona State University in Tempe, who was not part of the study.

The best time to begin this preventive therapy may be following a parent’s treatment for depression rather than during treatment, Sandler said.

Teen are actively learning new academic and social skills, and a person who is depressed most likely will fall behind his or her peers, he said.

“By relieving that depression, he or she will catch up to some degree and that could be reflected years later,” he said.

If a child appears to develop depressive symptoms, earlier intervention is better, Sandler said.

“Prevention services are not widely available because our health system does not reimburse for them, so it’s a real problem,” he said. Some programs are offered through schools or other community agencies.

Not everything offered as prevention really is evidence based, so parents need to do their homework and insist on programs that have been demonstrated to work and where the leaders are certified to be competent providers of the program,” noted Sandler.

phillyhealth.com

October 6, 2015