Cited by 249Child and Adolescent Psychosocial and Emotional DevelopmentSchool Health and Nursing EducationAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

A Randomized Placebo-Controlled Trial of a School-Based Depression Prevention Program

Merry, Sally, McDOWELL, HEATHER, Wild, Chris J., Bir, Julliet, Cunliffe, Rachel·2004·Journal of the American Academy of Child & Adolescent Psychiatry

Abstract

Objective To conduct a placebo-controlled study of the effectiveness of a universal school-based depression prevention program.Method Three hundred ninety-two students age 13 to 15 from two schools were randomized to intervention (RAP-Kiwi) and placebo programs run by teachers. RAP-Kiwi was an 11-session manual-based program derived from cognitive-behavioral therapy. The placebo was similar but with cognitive components removed. Outcomes were self-rated depression scales, the Reynolds Adolescent Depression Scale (RADS), and the Beck Depression Inventory II (BDI-II). Follow-up was to 18 months. Analysis was done on an intent-to-treat basis.Results Immediately after the intervention, depression scores were reduced significantly more by RAP-Kiwi than by placebo, with a mean difference in change from baseline between groups of 1.5 on BDI-II (CI > 0.38, p =.01) and 2.24 on RADS (CI > 0.22, p =.04). Categorical analysis confirmed significant clinical benefit with an absolute risk reduction of 3% (95% CI, 1-11%, McNemar chi, p =.03), with the "number needed to treat" for short-term benefit of 33. Group differences in depression scores averaged across time to 18 months were significant on RADS but not on BDI-II. Retention rates were 91% at 6 months and 72% at 18 months.Conclusions The RAP-Kiwi program is a potentially effective public health measure. Confirmation of effectiveness measuring episodes of depressive illness and broader measures of adjustment is warranted.

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Crossref · 10.1097/00004583-200405000-00007

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Authors
Merry, S., McDOWELL, H., Wild, C. J., Bir, J., & Cunliffe, R.
Affiliations
University of Auckland (NZ)
Corresponding author
Merry, Sally
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2004-05
Volume
43
Issue
5
Pages
538-547
ISSN
0890-8567 (ISSN-L)
OpenAlex
W2088454316
Cited by
249
References
40
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 19 · 2022: 7 · 2021: 8 · 2020: 8 · 2019: 11 · 2018: 7 · 2017: 13 · 2016: 14 · 2015: 11 · 2014: 18 · 2013: 9 · 2012: 20
FWCI
16.77
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
the Health Research Council (99/039)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression prevention, school-based intervention, adolescent depression, cognitive behavioral therapy, universal prevention programs, program retention, public health prevention
MeSH terms
Adolescent, Depression, Female, Humans, Male, Preventive Health Services, School Health Services, United States, Single-Blind Method

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