Preventing depression in final year secondary students: School-based randomized controlled trial
journal contributionposted on 22.07.2020, 01:36 by Y Perry, A Werner-Seidler, A Calear, A Mackinnon, C King, J Scott, S Merry, Theresa FlemingTheresa Fleming, K Stasiak, H Christensen, PJ Batterham
Background: Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment. Objective: This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to facing a significant stressor-final secondary school exams. It was hypothesized that delivering a prevention intervention in advance of a stressor would reduce depressive symptoms relative to the control group. Methods: A cluster randomized controlled trial was conducted in 10 government schools in Sydney, Australia. Participants were 540 final year secondary students (mean 16.7 [SD 0.51] years), and clusters at the school level were randomly allocated to SPARX-R or the control intervention. Interventions were delivered weekly in 7 modules, each taking approximately 20 to 30 minutes to complete. The primary outcome was symptoms of depression as measured by the Major Depression Inventory. Intention-to-treat analyses were performed. Results: Compared to controls, participants in the SPARX-R condition (n=242) showed significantly reduced depression symptoms relative to the control (n=298) at post-intervention (Cohen d=0.29) and 6 months post-baseline (d=0.21) but not at 18 months post-baseline (d=0.33). Conclusions: This is the first trial to demonstrate a preventive effect on depressive symptoms prior to a significant and universal stressor in adolescents. It demonstrates that an online intervention delivered in advance of a stressful experience can reduce the impact of such an event on the potential development or exacerbation of depression.
Preferred citationPerry, Y., Werner-Seidler, A., Calear, A., Mackinnon, A., King, C., Clin, M., Scott, J., Merry, S., Fleming, T., Stasiak, K., Christensen, H. & Batterham, P.J. (2017). Preventing depression in final year secondary students: School-based randomized controlled trial. Journal of Medical Internet Research, 19(11), 1-11. https://doi.org/10.2196/jmir.8241
Journal titleJournal of Medical Internet Research
PublisherJMIR Publications Inc.
Online publication date02/11/2017
Article numberARTN e369
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preventiondepressionadolescentdigital cognitive behavior therapyClinicalPublic HealthMental HealthClinical ResearchDepressionPediatricClinical Trials and Supportive ActivitiesBehavioral and Social SciencePrevention3.1 Primary prevention interventions to modify behaviours or promote well-beingAdolescentCognitive Behavioral TherapyFemaleHumansMaleStudentsCognitive TherapyScience & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesMedical InformaticsMAJOR DEPRESSIONSUICIDAL THOUGHTSMENTAL-HEALTHSTRESSADOLESCENTSPROGRAMANXIETYPOPULATIONINVENTORYVALIDITYPublic Health and Health ServicesInformation and Computing SciencesMedical and Health SciencesPsychology and Cognitive Sciences