Objective: This pilot study tests the efficacy of a 6-week, individual, cognitive-behavioral intervention, delivered by nurse practitioners in the primary health care setting to adolescents with elevated depressive symptoms and their parents. Population, Sample, Setting: Adolescents (aged 12-17 years) were recruited in five pediatrician’s offices in Upstate New York and screened for depressive symptoms using the Children’s Depression Inventory (CDI). Eligible (CDI score between 15-25) and consenting adolescents and their parents were randomized to an experimental (n=20) or control (n=20) group. Design: 2-group, experimental design. Main outcome variables: adolescent depression (CDI), depressogenic cognition (Dysfunctional Attitudes Scale), self-esteem (Rosenberg Self-Esteem Scale), and family communication problems (Family Assessment Device). Mediating variables: parent depression (Beck’s depression inventory), adolescent and parent anxiety (Spielberger State-Trait Anxiety Inventory), parent personal beliefs (Parent Beliefs Scale), and adolescent personal beliefs (Personal Beliefs Inventory). Methods: The experimental intervention is a modified replication of the Coping with Depression for Adolescents course (CWD-A) developed and researched by Lewinsohn and colleagues, at the Oregon Research Institute. The control group received routine adolescent health care information. Measures were collected at baseline, treatment completion, and 1-month post-intervention. Findings: Preliminary analysis demonstrates favorable outcomes for adolescents in the experimental group with subjects improving on the primary outcome variables. Final data collection and analysis will be completed by May, 2003. Conclusions: This is the first randomized experiment in primary care practice for depressed adolescents. If significant effect sizes are obtained, the study will be replicated as a full-scale, multi-site randomized controlled trial with more diverse samples to determine the effects of the intervention to improve mild depression and prevent major depression in adolescents. Implications: Early identification of adolescents with elevated depressive symptoms and timely, effective interventions are crucial fundamental principles to the prevention of major depressive disorders and the negative sequelae associated with severe depression.
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