title: Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention.
abstract: OBJECTIVE
  This investigation attempted to prevent unipolar depressive episodes in a sample of high school adolescents with an elevated risk of depressive disorder.
  
  
  METHODS
  Adolescents at risk for future depressive disorder by virtue of having elevated depressive symptomatology were selected with a two-stage case-finding procedure. The Center for Epidemiologic Studies-Depression Scale (CES-D) was administered to 1,652 students; adolescents with elevated CES-D scores were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Subjects with current affective diagnoses were referred to nonexperimental services. The remaining 150 consenting subjects were considered at risk for future depression and randomized to either a 15-session cognitive group prevention intervention or an "usual care" control condition. Subjects were reassessed for DSM-III-R diagnostic status after the intervention and at 6- and 12-month follow-up points.
  
  
  RESULTS
  Survival analyses indicated a significant 12-month advantage for the prevention program, with affective disorder total incidence rates of 14.5% for the active intervention, versus 25.7% for the control condition. No differences were detected for nonaffective disorders across the study period.
  
  
  CONCLUSIONS
  Depressive disorder can be successfully prevented among adolescents with an elevated future risk.
authors.affiliation: Oregon Health Sciences University, Psychiatry Department GH255, Portland 97201.
authors.forename: G N
authors.initials: GN
authors.lastname: Clarke
authors.forename: W
authors.initials: W
authors.lastname: Hawkins
authors.forename: M
authors.initials: M
authors.lastname: Murphy
authors.forename: L B
authors.initials: LB
authors.lastname: Sheeber
authors.forename: P M
authors.initials: PM
authors.lastname: Lewinsohn
authors.forename: J R
authors.initials: JR
authors.lastname: Seeley
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D016019:Survival Analysis; D016896:Treatment Outcome