Integrative internet-based depression prevention for adolescents: a randomized clinical trial in primary care for vulnerability and protective factors.
BACKGROUND
Adolescent depression is both a major public health and clinical problem, yet primary care physicians have limited intervention options. We developed two versions of an Internet-based behavioral intervention to prevent the onset of major depression and compared them in a randomized clinical trial in 13 US primary care practices.


METHODS
We enrolled 84 adolescents at risk for developing major depression and randomly assigned them to two groups: brief advice (BA; 1-2 minutes) + Internet program versus motivational interview (MI; 5-15 minutes) + Internet program. We compared pre/post changes and between group differences for protective and vulnerability factors (individual, family, school and peer).


RESULTS
Compared with pre-study values, both groups demonstrated declines in depressed mood; [MI: 21.2 to 16.74 (p < 0.01), BA: 23.34 to 16.92 (p < 0.001)]. Similarly, both groups demonstrated increases in social support by peers [MI: 8.6 to 12.1 (p = 0.002), BA: 7.10 to 12.5 (p < 0.001)] and reductions in depression related impairment in school [MI: 2.26 to 1.76 (p = 0.06), BA: 2.16 to 1.93 (p = 0.07)].


CONCLUSIONS
Two forms of a primary care/Internet-based behavioral intervention to prevent adolescent depression may lower depressed mood and strengthen some protective factors for depression.
Van Voorhees
Benjamin W
BW
Department of Medicine, The University of Chicago, Chicago, Illinois, USA. bvanvoor@medicine.bsd.uchicago.edu
Vanderplough-Booth
Karen
K
Fogel
Joshua
J
Gladstone
Tracy
T
Bell
Carl
C
Stuart
Scott
S
Gollan
Jackie
J
Bradford
Nathan
N
Domanico
Rocco
R
Fagan
Blake
B
Ross
Ruth
R
Larson
Jon
J
Watson
Natalie
N
Paunesku
Dave
D
Melkonian
Stephanie
S
Kuwabara
Sachiko
S
Holper
Tim
T
Shank
Nicholas
N
Saner
Donald
D
Butler
Amy
A
Chandler
Amy
A
Louie
Tina
T
Weinstein
Cynthia
C
Collins
Shannon
S
Baldwin
Melinda
M
Wassel
Abigail
A
Reinecke
Mark A
MA