title: Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial.
abstract: The main behavioral characteristic of subthreshold depression that is observed in adolescents is the low frequency of exposure to environmental rewards. Therefore, it was considered that a simple intervention conducted in short sessions, focusing on increasing access to positively reinforcing activities, would be efficacious in increasing the availability of rewards. We conduct a randomized controlled trial to examine the efficacy of such a behavioral activation program that was conducted weekly for 5 weeks in 60-min sessions. Late adolescent university students aged 18-19 years with subthreshold depression were randomly allocated to a treatment (n = 62) or a control group (n = 56). The primary outcome of the study was the Beck Depression Inventory-II score. Results indicated that late adolescent students in the treatment group showed significant improvements in their depressive symptoms (effect size -0.90, 95 % CI -1.28 to -0.51) compared to the control group. Students in the treatment group also showed significant improvements in self-reported rating of quality of life and in behavioral characteristics. It is concluded that this intervention had a large and significant effect despite being short and simple and that this low-intensity cognitive behavioral therapy program could be conducted in many different types of institutions. It is suggested that the long-term effects of the treatment program should be targeted for investigation in future studies.
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Takagaki
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. oy@hiroshima-u.ac.jp.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Ran
authors.initials: R
authors.lastname: Jinnin
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Mori
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Takanao
authors.initials: T
authors.lastname: Yamamura
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Syouichi
authors.initials: S
authors.lastname: Shiota
authors.affiliation: Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshimashi, Hiroshima, 739-8511, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshimashi, Hiroshima, 739-8511, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Miyake
authors.affiliation: Department of Psychology, Hiroshima University, 1-1-1, Kagamiyama, Higashihiroshimashi, Hiroshima, 739-8511, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogata
authors.affiliation: Department of Psychology, School of Human Sciences, Senshu University, 2-1-1, Higashi-Mita, Tama, Kawasaki, 214-8580, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kunisato
authors.affiliation: Department of Psychiatry of Mental Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Shimoda
authors.affiliation: Department of Psychiatry of Mental Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.affiliation: Department of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyouto University Graduate school of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
authors.forename: Toshi A
authors.initials: TA
authors.lastname: Furukawa
authors.affiliation: Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012201:Reward; D016896:Treatment Outcome; D055815:Young Adult
keywords: Behavioral activation; Late adolescent; Randomized controlled trial; Subthreshold depression