Study Adolescent depression

International studies have shown that CBT is effective in reducing depressive symptoms in depressed adolescents. However, there is no consensus on the degree of effectiveness. Effectsizes of meta-analyses range from 0.34 (Weisz et al., 2006) to 0.53 (for CBT; Klein et al., 2007). The D(o)epression course is an individual CBT program which is developed specifically for adolescents with a clinical depression. It is a revision of the group protocol 'Coping with depression course for Adolescents (CWD-A)' (Clarke et al., 1990). Results repeatedly show that the CWD-A is effective (e.g. Clarke et al., 2002). However, the CWD-A is only regarded as probably efficacious (David-Ferdon & Kaslow, 2008), it's effectiveness has not been investigated yet. Furthermore, in the Netherlands, there is no study supporting the use of CBT as an evidence based intervention for adolescent depression.

Aim of this study was to test the effectiveness of a specific CBT program for adolescents diagnosed with depression and to establish the cost-effectiveness of this program under rigorous conditions, within routine care provided by professionals already working in mental health institutions. Cost-of-illness of clinical depression in adolescents, potential moderators (gender, age, comorbidity, e.g.), mediators (negative automatic thoughts, cognitive emotion regulation, e.g.) and non-specific treatment variables (therapeutic alliance, client expectancy, e.g.) were also assessed.

In this multi-site, randomised controlled trial individual CBT (D(o)epressie) was compared to care as usual. Recruitment was done in 14 specialized mental health care institutions in the Netherlands. In total, 100 adolescents (12 to 21 years old) were included and 4 assessments were conducted (pre, post, 6 months and 1 year follow-up). Assessments consist of questionnaires and diagnostic interviews with the parent, the adolescent and the therapist. During the treatment two mediator assessments were conducted.

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