Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12-week outcomes.
OBJECTIVE
The authors sought to evaluate 2 approaches with varying time and complexity in engaging adolescents with an Internet-based preventive intervention for depression in primary care. The authors conducted a randomized controlled trial comparing primary care physician motivational interview (MI, 5-10 minutes) + Internet program versus brief advice (BA, 1-2 minutes) + Internet program.


METHODS
Adolescent primary care patients in the United States, aged 14 to 21 years.


METHODS
Eighty-four individuals (40% non-white) at increased risk for depressive disorders (subthreshold depressed mood >3-4 weeks) were randomly assigned to either the MI group (n = 43) or the BA group (n = 40).


METHODS
Patient Health Questionnaire-Adolescent and Center for Epidemiologic Studies Depression Scale (CES-D).


RESULTS
Both groups substantially engaged the Internet site (MI, 90.7% vs BA 77.5%). For both groups, CES-D-10 scores declined (MI, 24.0 to 17.0, p < .001; BA, 25.2 to 15.5, p < .001). The percentage of those with clinically significant depression symptoms based on CES-D-10 scores declined in both groups from baseline to 12 weeks, (MI, 52% to 12%, p < .001; BA, 50% to 15%, p < .001). The MI group demonstrated declines in self-harm thoughts and hopelessness and was significantly less likely than the BA group to experience a depressive episode (4.65% vs 22.5%, p = .023) or to report hopelessness (MI group of 2% vs 15% for the BA group, p = .044) by 12 weeks.


CONCLUSIONS
An Internet-based prevention program in primary care is associated with declines in depressed mood and the likelihood of having clinical depression symptom levels in both groups. Motivational interviewing in combination with an Internet behavior change program may reduce the likelihood of experiencing a depressive episode and hopelessness.
Van Voorhees
Benjamin W
BW
Section of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.
Fogel
Joshua
J
Reinecke
Mark A
MA
Gladstone
Tracy
T
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
Vanderplough-Booth
Karin
K
Humensky
Jennifer
J
Bell
Carl
C
D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D009042:Motivation; D011320:Primary Health Care / Q000379:methods; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult