Patrick Smith1, Rebecca Scott2, Ertimiss Eshkevari2, Fatoumata Jatta2, Eleanor Leigh3, Victoria Harris4, Alex Robinson2, Paul Abeles5, Judy Proudfoot6, Chrissie Verduyn5, William Yule2. 1. Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Mood Disorder Clinic for Children and Young People, Michael Rutter Centre, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK. Electronic address: patrick.smith@kcl.ac.uk. 2. Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, King's College London, London SE5 8AF, UK. 3. Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Mood Disorder Clinic for Children and Young People, Michael Rutter Centre, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK. 4. Department of Biostatistics, Institute of Psychiatry Psychology & Neuroscience, King's College London, London SE5 8AF, UK. 5. Central Manchester University Hospitals NHS Foundation Trust, Harrington Building, Royal Manchester Children's Hospital, Oxford Road, M13 9WL, UK. 6. Black Dog Institute, University of New South Wales, Hospital Road, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
Abstract
BACKGROUND: Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. AIMS: To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. METHOD: Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. RESULTS: Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. CONCLUSIONS:C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents.
RCT Entities:
BACKGROUND:Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. AIMS: To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. METHOD: Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. RESULTS: Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. CONCLUSIONS: C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents.
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