Family Check-Up for Depression Prevention

描述（由申请人提供）：非常需要新的研究和开发抑郁症预防计划。在过去的几年里，我们已经开始开发家庭检查（FCU），这是一种针对家庭功能的简短家庭干预措施，可能对预防抑郁症有效。FCU是仿照米勒，主权，和Krege，（1988年）所描述的饮酒者的检查。与饮酒者检查一样，FCU由评估、反馈和目标设定组成，并使用激励性面试风格进行。FCU设计用于成人和年龄较大的青少年。由于不良的家庭功能是抑郁症的一个重要风险因素，我们相信FCU将通过改善家庭功能来预防抑郁症。 在本申请中，我们建议继续治疗开发的过程。FCU（n = 32个家庭）的开放试验的初步证据表明，它是可以接受的家庭，它与抑郁症状和家庭功能的改善。在这一点上，需要进一步的开发和试点测试，在该项目的第一阶段，我们建议专门针对非洲裔美国人和拉丁裔家庭进行FCU的公开试验。这将使我们能够确保不同文化和种族群体的观点纳入治疗开发。我们还将创建依从性和能力措施，以及临床医生培训计划。在拟议项目的第2阶段，我们将在多民族和多种族的家庭样本（n = 60）中进行FCU作为抑郁症选择性预防计划的试点随机对照试验。将FCU与最小治疗对照组进行比较。报告家庭功能不佳且至少有一名家庭成员近期有抑郁症病史（但目前没有重度抑郁症或心境恶劣）的家庭将有资格参加。家庭成员将在随机化后随访6个月，主要结局变量将是基线和6个月随访之间至少有亚综合征抑郁水平的周数。次要结果变量包括重度抑郁发作的发生率和家庭功能的变化。II期试验的目的是获得更大规模随机对照试验的效应量估计值。

DESCRIPTION (provided by applicant): There is a great need for new research and development of depression prevention programs. Over the past few years, we have begun to develop the Family Check-Up (FCU), a brief family intervention that targets family functioning and may be effective in preventing depression. The FCU is modeled on the Drinker's Check-up, as described by Miller, Sovereign, & Krege, (1988). Like the Drinker's Check-Up, the FCU consists of assessment, feedback, and goal-setting, and is conducted using a motivational interviewing style. The FCU is designed for use with adults and older adolescents. Because poor family functioning is a significant risk factor for depression, we believe that the FCU will prevent depression by improving family functioning. In the current application, we propose to continue the process of treatment development. Preliminary evidence from an open trial of the FCU (n = 32 families) suggests that it is acceptable to families and that it is associated with improvements in depression symptoms and family functioning. At this point, further development and pilot testing are needed, hi Phase 1 of this project, we propose to conduct an open trial of the FCU specifically with African-American and Latino families. This will allow us to ensure that perspectives of different cultural and racial groups are included in treatment development. We will also create adherence and competency measures, and a clinician-training program, hi Phase 2 of the proposed project, we will conduct a pilot randomized controlled trial of the FCU as a selective prevention program for depression in a multi-ethnic and multi-racial sample of families (n = 60). The FCU will be compared to a minimal treatment control group. Families who report poor family functioning and have at least one family member with a recent history of depression (but no current major depression or dysthymia) will be eligible to participate. Family members will be followed for 6-months after being randomized, and the primary outcome variable will be number of weeks with at least a subsyndromal level of depression between baseline and 6- month follow-up. Secondary outcome variables include incidence of major depressive episodes and change in family functioning. The purpose of Phase 2 is to gain an estimate of effect size for a larger randomized controlled trial.