Project Overview:

This multi-site study was designed to evaluate CATCH-IT, a primary care, internet-based depression prevention program for at-risk adolescents and their families. CATCH-IT, which stands for Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training, is based on face-to-face interventions of demonstrated efficacy.

This evaluation study combined a sustained motivational program delivered to adolescents by their pediatricians with an internet-based intervention that aimed to help teens understand the connection between their thoughts and moods, the importance of activity scheduling, and the relation between depression and interpersonal functioning. In addition, a parent program was designed to educate parents about youth depression, treatment options, and ways to promote resilience in their teens. Pilot work with this intervention suggested that it is associated with significant reductions in a depressed mood, increased social support, and reduced depressive episodes at 3 and 12-month follow-up in a diverse population.

Study Design:

In this 5-year, two-site (Chicago and Boston) randomized clinical trial, the efficacy of the CATCH-IT intervention was compared to an educational control condition in preventing the onset of depressive episodes in an intermediate to high risk, geographically representative sample of adolescents aged 13-18. The researchers (a) identified high-risk adolescents based on elevated scores on a screening measure of depressive symptoms that was delivered in primary care; (b) recruited 400 (200 per site) of these at-risk adolescents who were randomized into either the CATCH-IT or the Educational group; and (c) assessed outcomes at 2, 6, 12, 18 and 24 months post intake on measures of depressive symptoms, depressive diagnoses, other mental disorders, and on measures of role impairment in education, quality of life, attainment of educational milestones, and family functioning; and examined predictors of intervention response and potential ethnic and cultural differences in intervention response.

Findings:

Of 369 participants included in this trial, 193 were randomized into CATCH-IT and 176 into the educational control group. In both groups, depression symptoms declined. Adolescents in the CATCH-IT program who were at-risk for depression may have experienced fewer depressive episodes. This suggested that for preventing depressive episodes, CATCH-IT may be better than general health education for at-risk adolescents who do not yet have a major depressive disorder but are experiencing symptoms of depression.