title: Computerised cognitive-behavioural therapy for depression in adolescents: feasibility results and 4-month outcomes of a UK randomised controlled trial.
abstract: Computer-administered cognitive-behavioural therapy (CCBT) may be a promising treatment for adolescents with depression, particularly due to its increased availability and accessibility. The feasibility of delivering a randomised controlled trial (RCT) comparing a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression was evaluated.
  
  
  
  Single centre RCT feasibility study.
  
  
  
  The trial was run within community and clinical settings in York, UK.
  
  
  
  Adolescents (aged 12-18) with low mood/depression were assessed for eligibility, 91 of whom met the inclusion criteria and were consented and randomised to Stressbusters (n=45) or websites (n=46) using remote computerised single allocation. Those with comorbid physical illness were included but those with psychosis, active suicidality or postnatal depression were not.
  
  
  
  An eight-session CCBT program (Stressbusters) designed for use with adolescents with low mood/depression was compared with an attention control (accessing low mood self-help websites).
  
  
  
  Participants completed mood and quality of life measures and a service Use Questionnaire throughout completion of the trial and 4 months post intervention. Measures included the Beck Depression Inventory (BDI) (primary outcome measure), Mood and Feelings Questionnaire (MFQ), Spence Children's Anxiety Scale (SCAS), the EuroQol five dimensions questionnaire (youth) (EQ-5D-Y) and Health Utility Index Mark 2 (HUI-2). Changes in self-reported measures and completion rates were assessed by treatment group.
  
  
  
  From baseline to 4 months post intervention, BDI scores and MFQ scores decreased for the Stressbusters group but increased in the website group. Quality of life, as measured by the EQ-5D-Y, increased for both groups while costs at 4 months were similar to baseline. Good feasibility outcomes were found, suggesting the trial process to be feasible and acceptable for adolescents with depression.
  
  
  
  With modifications, a fully powered RCT is achievable to investigate a promising treatment for adolescent depression in a climate where child mental health service resources are limited.
  
  
  
  ISRCTN31219579.
authors.affiliation: University of York (Child Oriented Mental health Intervention Centre - COMIC), Adolescent and Family Unit, York, UK.
authors.forename: Barry
authors.initials: B
authors.lastname: Wright
authors.affiliation: Leeds and York Partnership NHS Foundation Trust (Child Oriented Mental health Intervention Centre - COMIC), York, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Tindall
authors.affiliation: The University of York, York, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Littlewood
authors.affiliation: The University of York, York, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Allgar
authors.affiliation: Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Abeles
authors.affiliation: The University of York, York, UK.
authors.forename: Dominic
authors.initials: D
authors.lastname: Trépel
authors.affiliation: The University of York, York, UK.
authors.forename: Shehzad
authors.initials: S
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D057240:Patient Preference; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Adolescents; Depression; Randomised Controlled Trial; computerised Cognitive Behaviour Therapy