Internet Program Helps Prevent Depression in Teens

A study reports an Internet program helps to reduce depressive symptoms and prevent episodes of clinical depression in adolescent patients at risk.

An Internet program called "Project CATCH-IT," 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. 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. 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. The program includes a series of 14 modules that the teens can work through privately on a secure website. A version of Project CATCH-IT for use by physicians and the general public is available online at http://catchit public.bsd.uchicago.edu/. 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 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. 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. The researchers 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.