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A randomized placebo-controlled trial of a school-based depression prevention program.
Sally Merry1, Heather McDowell, Chris J Wild
1Department of Psychiatry, University of Auckland, Auckland, New Zealand. s.merry@auckland.ac.nz
Summary
The RAP-Kiwi school program significantly reduced depression scores in adolescents compared to a placebo. This cognitive-behavioral intervention shows promise as a public health measure for youth depression prevention.
Area of Science:
- Adolescent mental health
- Public health interventions
- School-based programs
Background:
- Adolescent depression is a significant public health concern.
- Early intervention and prevention programs are crucial for youth well-being.
- School settings offer a viable platform for universal prevention strategies.
Purpose of the Study:
- To evaluate the effectiveness of a universal school-based depression prevention program called RAP-Kiwi.
- To compare RAP-Kiwi to a placebo control in adolescents aged 13-15.
- To assess short-term and long-term impacts on depression symptoms.
Main Methods:
- A randomized controlled trial involving 392 students in two schools.
- Intervention group received the 11-session manual-based RAP-Kiwi program (cognitive-behavioral therapy).
- Control group received a placebo program without cognitive components; outcomes measured by RADS and BDI-II, with 18-month follow-up.
Main Results:
- Immediately post-intervention, RAP-Kiwi significantly reduced depression scores on both BDI-II and RADS compared to placebo.
- Clinical benefit was confirmed with a 3% absolute risk reduction and NNT of 33 for short-term benefit.
- Long-term differences were significant on RADS but not BDI-II; retention rates were 72% at 18 months.
Conclusions:
- The RAP-Kiwi program demonstrates potential effectiveness as a public health intervention for adolescent depression.
- Further research is needed to confirm effectiveness using measures of depressive illness episodes and broader adjustment.
- School-based cognitive-behavioral programs can be a valuable tool in youth mental health.