Depression Prevention Initiative: A Study of IPT-AST in School Settings

描述（由申请人提供）：青少年抑郁症是一种高度流行的疾病，与多种障碍有关（Fergusson & Woodward，2002）。这引起了人们对制定预防和早期干预抑郁症的方案的兴趣，特别是可以在儿童和青少年最有可能接受服务的学校提供的方案（总统心理健康新自由委员会，2003年）。基于对抑郁症创新预防方案的需求以及在学校提供这种干预的优势，我们开发了一个以学校为基础的小组，指示预防干预，人际心理治疗青少年技能培训（IPT AST; Young & Mufson，2003）。在两项小规模随机对照试验中，IPT-AST在干预后立即显着有效，并且在6个月随访时效果持续（Young，Mufson，& Davies，2006 a; Young，Mufson，& Gallop，2009）。下一个合乎逻辑的步骤是进行一项大规模的疗效研究，将IPT-AST与更严格的对照条件进行比较，并检查IPT-AST结果的中介者和调节者。这项研究是一项随机对照试验，比较了IPT-AST和团体咨询（GC）预防青少年抑郁症的效果。该项目将：（1）识别抑郁症状升高但不符合当前心境障碍诊断标准的青少年;（2）将符合条件的青少年随机分为IPT-AST（N = 100）或GC（N = 100）;（3）在基线、干预中期、干预后评估抑郁症状、抑郁障碍、整体功能、人际功能、共病状况和学校相关指标，在6个月、12个月、18个月和24个月随访时;（4）检查IPT-AST对抑郁症和每个时间点的各种功能领域的影响;（5）进行分析，以检查IPT-AST和抑郁症结局之间相关性的潜在介质和调节剂。这项研究将产生关于IPT-AST相对于GC预防抑郁症状和抑郁障碍的疗效的数据。它还将提供有关IPT-AST作用机制的信息，并确定IPT-AST对谁最有效。 公共卫生相关性：本研究的主要目的是测试人际心理治疗-青少年技能训练（IPT-AST）的有效性，这是一项针对抑郁症状加重的青少年的预防计划。如果有效，IPT-AST可以由学校辅导员实施。这将使更多的青少年在达到抑郁症标准之前获得帮助，并带来相关的损害和社会成本。

DESCRIPTION (provided by applicant): Adolescent depression is a highly prevalent condition that is associated with multiple impairments (Fergusson & Woodward, 2002). This has led to an interest in developing programs for the prevention and early intervention of depression, particularly programs that can be delivered in schools where children and adolescents are most likely to receive services (President's New Freedom Commission on Mental Health, 2003). Based on the need for innovative prevention programs for depression and the advantages of delivering such an intervention in schools, we developed a school-based group indicated preventive intervention, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST; Young & Mufson, 2003). In two small-scale randomized controlled trials, IPT-AST has been markedly efficacious immediately post-intervention and the effects are sustained at six month follow-up (Young, Mufson, & Davies, 2006a; Young, Mufson, & Gallop, 2009). The next logical step is to conduct a large-scale efficacy study comparing IPT-AST to a more rigorous control condition and to examine mediators and moderators of IPT-AST outcomes. The proposed study is a randomized controlled trial comparing IPT-AST to group counseling (GC) for the prevention of depression in adolescents. The project will: (1) identify adolescents with elevated depressive symptoms but who do not meet criteria for a current mood disorder diagnosis; (2) randomize eligible adolescents to either IPT-AST (N = 100) or GC (N = 100); (3) assess depressive symptoms, depressive disorders, global functioning, interpersonal functioning, comorbid conditions and school related indices at baseline, mid-intervention, post-intervention, and at 6-, 12-, 18-, and 24-month follow-up; (4) examine the effects of IPT-AST on depression and various domains of functioning at each time point; and (5) conduct analyses to examine potential mediators and moderators of the association between IPT-AST and depression outcomes. This study will yield data on the efficacy of IPT-AST relative to GC for the prevention of depressive symptoms and depressive disorders. It will also provide information about the mechanisms of action of IPT-AST and determine for whom IPT-AST is most effective. PUBLIC HEALTH RELEVANCE: The primary goal of this study is to test the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a prevention program for adolescents with elevated depression symptoms. If efficacious, IPT-AST can be implemented by school counselors. This will allow more adolescents to receive help before they meet criteria for depression, with its associated impairments and societal costs.