Impact of Increasing Adolescent Depression Literacy on Treatment-Seeking Behavior

提高青少年抑郁素养对寻求治疗行为的影响

• 批准号: 8517202
• 负责人: Holly C Wilcox
• 金额: $ 54.72万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8517202
• 关键词: 19 year old; Address; Adolescence; Adolescent; Adult; Affect; Age; Anxiety Disorders; Autopsy; Awareness; Behavior; Bipolar Depression; Cessation of life; Characteristics; Communities; Community Mental Health Services; Comorbidity; Controlled Study; County; Development; Early identification; Early treatment; Education; Educational Curriculum; Effectiveness; Family; Family Relationship; Goals; Health; Health education; Home environment; Hour; Human Resources; Impairment; Indian reservation; Intervention; Knowledge; Life; Major Depressive Disorder; Measures; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mission; Morbidity - disease rate; Nurse Psychotherapist; Oklahoma; Parents; Patient Self-Report; Pennsylvania; Prevalence; Prevention; Professional counselor; Psychiatric Nursing; Psychiatrist; Publishing; Randomized; Recurrence; Reporting; Research; Risk; Role; Schools; Social Work; Students; Substance Addiction; Suicide; Symptoms; Teenagers; Testing; Time; Training; Underachievement; Unemployment; Unipolar Depression; United States; United States Indian Health Service; United States Substance Abuse and Mental Health Services Administration; Universities; Visit; Work; Youth; base; depression education; depressive symptoms; design; disability; effective therapy; effectiveness trial; emerging adult; experience; help-seeking behavior; high school; high standard; improved; intervention program; literacy; medical schools; mortality; ninth grade; peer; post intervention; programs; psychologic; randomized trial; school health; single episode major depressive disorder; social; social stigma; teacher; universal prevention; young adult

DESCRIPTION (provided by applicant): This large-scale randomized school-based effectiveness trial will study whether the Adolescent Depression Awareness Program (ADAP), a program that has shown in one group pre-post and nonrandomized controlled studies to increase depression literacy among adolescents, has an impact on treatment-seeking behaviors. Depression is prevalent, costly and a major cause of disability and death worldwide. The onset of depression often occurs early in life, during teen or young adult years as 21-28 percent of adolescents experience an episode of major depression by the age of 19 years. The onset of depression during adolescence is associated with increased risk for Major depression during adulthood, substance dependence, educational underachievement, unemployment, and early parenthood. These difficulties are also often evident in adolescents with subclinical levels of depression. Depression has substantial continuity into adulthood with impaired functioning in work, social, and family life. The most severe consequence of untreated depression is suicide. Despite the high proportion of adolescents affected and disability associated with depression, there have been few large-scale school-based randomized trials investigating the effectiveness of universal interventions targeting depression among adolescents; and the results from these studies have been mixed. ADAP, a school-based depression education program developed in 1999 by a team of psychiatrists and psychiatric nurses from the Johns Hopkins University School of Medicine, has been implemented in 85 schools throughout the United States with over 20,000 ninth grade students. ADAP is delivered by school-personnel (trained health education teachers) as part of the standard high school health education curriculum. A randomized trial of the ADAP's effectiveness has not yet been conducted. We propose to assess the effectiveness of ADAP in increasing depression literacy and treatment seeking among adolescents in 66 schools (n=15,000) in five regions of the United States using a randomized, universal school-based effectiveness trial. We will also identify possible mediators and moderators of intervention impact (e.g., access to community mental health services, teacher characteristics, school characteristics, stigma, and fidelity).

描述(由申请人提供)：这项大规模的随机校本有效性试验将研究青少年抑郁意识计划(ADAP)是否对寻求治疗的行为产生影响。ADAP是一组事前和非随机对照研究中显示的一项计划，旨在提高青少年的抑郁症素养。抑郁症很普遍，代价高昂，是全世界残疾和死亡的主要原因。抑郁症的发病通常发生在生命的早期，在青少年或青年时期，21%-28%的青少年在19岁之前经历了一次严重的抑郁症发作。青春期抑郁症的发作与成年后患重度抑郁症的风险增加、物质依赖、教育成就低下、失业和为人父母的早期有关。这些困难在患有亚临床抑郁症的青少年中也经常很明显。抑郁症会持续到成年，在工作、社交和家庭生活中的功能受损。未经治疗的抑郁症最严重的后果是自杀。尽管与抑郁症相关的青少年受影响和残疾的比例很高，但很少有大规模的以学校为基础的随机试验，调查针对青少年抑郁症的普遍干预措施的有效性；这些研究的结果喜忧参半。ADAP是由约翰·霍普金斯大学医学院的精神病学家和精神科护士组成的团队于1999年开发的一项以学校为基础的抑郁症教育项目，已在全美85所学校实施，有超过2万名九年级学生。ADAP由学校人员(受过培训的健康教育教师)教授，作为标准高中健康教育课程的一部分。尚未对ADAP的有效性进行随机试验。我们建议使用一项随机的、普遍的基于学校的有效性试验来评估ADAP在提高美国五个地区66所学校(n=15,000)青少年抑郁症识别率和寻求治疗方面的有效性。我们还将确定干预影响的可能调解人和调解人(例如，获得社区精神卫生服务的机会、教师特征、学校特征、污名和忠诚度)。