Indicated school-based intervention to improve depressive symptoms among at risk Chilean adolescents: a randomized controlled trial.
Indicated school-based intervention to improve depressive symptoms among at risk Chilean adolescents: a randomized controlled trial.
复制标题
DOI：
10.1186/s12888-016-0985-4
复制
发表时间：
2016-08-04
期刊：
影响因子：
4.4
通讯作者：
Araya R
中科院分区：
文献类型：
--
作者：
Gaete J;Martinez V;Fritsch R;Rojas G;Montgomery AA;Araya R
抑郁症是一种影响所有年龄段人群的致残性疾病，但通常始于青春期。学校似乎是提供预防性干预措施的绝佳场所。本研究旨在测试以学校为基础的干预措施对减少低收入家庭高危青少年抑郁症状的有效性。在智利圣地亚哥社会经济脆弱地区的 11 所中学进行了一项双臂、平行、随机对照试验。 10 年级（2°Medio）的高风险学生被邀请参加基线评估（n = 1048）。 BDI-II 得分≥10（男孩）和≥15（女孩）的受试者被邀请参加试验（n = 376）。共有 342 名学生同意，并以 2:1 的比例随机分配到干预组或对照组。干预措施包括 8 组课程，每组课程 45 分钟，基于认知行为模型，由学校的两名训练有素的心理学家进行。主要 (BDI-II) 和次要结果（焦虑、自动思维和解决问题能力的测量）在干预前和干预后 3 个月进行。主要结果是恢复率，定义为完成干预后 3 个月时 BDI-II 得分 <10（男孩）和 <15（女孩）的参与者比例。干预组有 229 名参与者，对照组有 113 名参与者。在 3 个月的随访中，干预组中有 81.4% 的人提供了结果数据，对照组中有 81.7% 的人提供了结果数据。干预组的恢复率 (50.3%) 比对照组 (40.2%) 高 10%；调整后的 OR = 1.62（95% CI：0.95 至 2.77）（p = 0.08）。任何次要结果均未发现组间差异。二次分析揭示了组与基线 BDI-II 评分之间的交互作用。我们没有发现明确的证据表明基于认知行为模型的简短、明确的基于学校的干预措施对于减少来自低收入家庭的智利青少年的抑郁症状是有效的。需要更多的研究来找到更好的解决方案来预防青少年抑郁症。当前对照试验 ISRCTN33871591。追溯注册日期为 2011 年 6 月 29 日。本文的在线版本 (doi:10.1186/s12888-016-0985-4) 包含补充材料，可供授权用户使用。
Depression is a disabling condition affecting people of all ages, but generally starting during adolescence. Schools seem to be an excellent setting where preventive interventions may be delivered. This study aimed to test the effectiveness of an indicated school-based intervention to reduce depressive symptoms among at-risk adolescents from low-income families. A two-arm, parallel, randomized controlled trial was conducted in 11 secondary schools in vulnerable socioeconomic areas in Santiago, Chile. High-risk students in year 10 (2° Medio) were invited to a baseline assessment (n = 1048). Those who scored ≥10 (boys) and ≥15 (girls) in the BDI-II were invited to the trial (n = 376). A total of 342 students consented and were randomly allocated into an intervention or a control arm in a ratio of 2:1. The intervention consisted of 8 group sessions of 45 min each, based on cognitive-behavioural models and delivered by two trained psychologists in the schools. Primary (BDI-II) and secondary outcomes (measures of anxiety, automatic thoughts and problem-solving skills) were administered before and at 3 months post intervention. The primary outcome was the recovery rate, defined as the proportion of participants who scored in the BDI-II <10 (among boys) and <15 (among girls) at 3 months after completing the intervention. There were 229 participants in the intervention group and 113 in the control group. At 3-month follow-up 81.4 % in the intervention and 81.7 % in the control group provided outcome data. The recovery rate was 10 % higher in the intervention (50.3 %) than in the control (40.2 %) group; with an adjusted OR = 1.62 (95 % CI: 0.95 to 2.77) (p = 0.08). No difference between groups was found in any of the secondary outcomes. Secondary analyses revealed an interaction between group and baseline BDI-II score. We found no clear evidence of the effectiveness of a brief, indicated school-based intervention based on cognitive-behavioural models on reducing depressive symptoms among Chilean adolescents from low-income families. More research is needed in order to find better solutions to prevent depression among adolescents. Current Controlled Trials ISRCTN33871591. Retrospectively registered 29 June 2011. The online version of this article (doi:10.1186/s12888-016-0985-4) contains supplementary material, which is available to authorized users.