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Screening and early psychological intervention for depression in schools

Systematic review and meta-analysis

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Abstract

Depression in children and adolescents is considerably undertreated, and the school may be a good setting for identifying and treating depression. We conducted a meta-analysis of studies in which students were screened for depression, and those with depressive symptoms were treated with a psychological intervention. Only randomised controlled trials were included. Eight studies met the inclusion criteria. Five studies focused on younger children (7–14 years) and three studies were aimed at adolescents (12–19 years). In total 5803 students were screened, of whom 7.2% were included in the intervention studies (95% CI: 7.1–7.3). The ‘numbers-needed-to-screen’ was 31 (95% CI: 27–32), which means that 31 students had to be screened in order to generate one successfully treated case of depression. The effects of the psychological treatments at post-test were compared to control conditions in the 8 studies comprising 12 contrast groups, with a total of 413 students. The mean effect size was 0.55 (95% CI: 0.35–0.76). There were not enough studies to examine whether specific psychotherapies were superior to other psychotherapies. Although the number of studies is small and their quality is limited, screening and early intervention at schools may be an effective strategy to reduce the burden of disease from depression in children and adolescents. More research on the (negative) effects of these interventions is needed.

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References

  1. American Academy of Child and Adolescent Psychiatry (1998) Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 37(10suppl):63S–83S

    Google Scholar 

  2. Asarnow JR, Jaycox LH, Tompson MC (2001) Depression in youth: psychosocial interventions. J Clin Child Psychol 30:33–47

    Article  PubMed  CAS  Google Scholar 

  3. Beich A, Thorsen T, Rollnick S (2003) Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis. BMJ 327:536–542

    Article  PubMed  Google Scholar 

  4. Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B (1996) Childhood and adolescent depression, I: a review of the past 10 years. J Am Acad Child Adolsc Psychiatry 35:1427–1439

    Article  CAS  Google Scholar 

  5. Clarke GN, Hawkins W, Murphy M, Sheeber LB, Lewinsohn PM, Seeley JR (1995) Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. J Am Acad Child Adolesc Psychiatry 34:312–321

    Article  PubMed  CAS  Google Scholar 

  6. Clarke GN, Hornbrook M, Lynch F, Polen M, Gale J, Beardslee W, O’Connor E, Seeley J (2001) A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Arch Gen Psychiatry 58:1127–1134

    Article  PubMed  CAS  Google Scholar 

  7. Cuijpers P, Dekker J (2005) Psychologische behandeling van depressie: een systematisch overzicht van meta-analyses. Ned Tijdschr Geneeskunde 149:1892–1897

    CAS  Google Scholar 

  8. Cuijpers P, Dekker J, van der Feltz-Cornelis C, Smit F (2006) Psychological treatment of depression: A systematic review of meta-analyses. Submitted

    Google Scholar 

  9. De Cuyper S, Timbremont B, Braet C, De Backer V, Wullaert T (2004) Treating depressive symptoms in schoolchildren: a pilot study. Eur Child Adol Psychiatry 13:105–114

    Article  Google Scholar 

  10. Gillham JE, Shatté AJ, Freres DR (2000) Preventing depression: a review of cognitive-behavioral and family interventions. Appl Prev Psychol 9:63–88

    Article  Google Scholar 

  11. Haby MM, Tonge B, Littlefield L, Carter R, Vos T (2004) Cost-effectiveness of cognitive behavioural therapy and selective serotonin reuptake inhibitors for major depression in children and adolescents. Austr New Zealand J Psychiatry 38:579–591

    Article  Google Scholar 

  12. Harrington R, Whittaker J, Shoebridge P (1998) Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ 316:1559–1563

    PubMed  CAS  Google Scholar 

  13. Harrington R, Whittaker J, Shoebridge P, Campbell F (1998) Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ 316:1559–1563

    PubMed  CAS  Google Scholar 

  14. Harrington R, Clark A (1998) Prevention and early intervention for depression in adolescence and early adult life. Eur Arch Psychiatry Neurosci 248:32–45

    Article  CAS  Google Scholar 

  15. Higgins JPT, Green S (2005) Cochrane handbook for systematic reviews of interventions 4.2.5 [updated May 2005]. In: The Cochrane Library, Issue 3, 2005. John Wiley & Sons, Ltd., Chichester, UK

  16. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327: 557–560

    Article  PubMed  Google Scholar 

  17. Jaycox LH, Reivich KJ, Gillham J, Seligman MEP (1994) Prevention of depressive symptoms in school children. Behav Res Ther 32:801–816

    Article  PubMed  CAS  Google Scholar 

  18. Kahn J, Kehle T, Jenson W, Clark E (1990) Comparison of cognitive-behavioral, relaxation, and self-modeling interventions for depression among middle-school students. School Psychol Rev 19:196–211

    Google Scholar 

  19. Lamb JM, Puskar KR, Sereika SM, Corcoran M (1998) School-based intervention to promote coping in rural teens. MCN Am J Matern Child Nurs 23:187–194

    Article  PubMed  CAS  Google Scholar 

  20. Lewinsohn PM, Clarke GN (1999) Psychosocial treatments for adolescent depression. Clin Psychol Rev 19:329–342

    Article  PubMed  CAS  Google Scholar 

  21. Lewinsohn PM, Hops H, Roberts RE, Seeley JR, Andrews JA (1993) Adolescent psychopathology, I: prevalence and incidence of depression and oterh DSM-III-R disorders in high school students. J Abnorm Psychol 102:133–144

    Article  PubMed  CAS  Google Scholar 

  22. Liddle B, Spence SH (1990) Cognitive-behaviour therapy with depressed primary school children: a cautionary note. Behav Psychother 18:85–102

    Article  Google Scholar 

  23. Lipsey MW, Wilson DB (1993) The efficacy of psychological, educational and behavioral treatment. Amer Psychol 48:1181–1209

    Article  CAS  Google Scholar 

  24. Merry S, McDowell H, Hetrick S, Bir J, Muller N (2004) Psychological and/or educational interventions for the prevention of depression in children and adolescents. The Cochrane Database of Systematic Reviews Issue 2. Art. No.: CD003380. DOI: 10.1002/14651858.CD003380.pub2

  25. Michael KD, Crowley SL (2002) How effective are treatments for child and adolescent depression? A meta-analytic review. Clin Psychol Rev 22:247–269

    Article  PubMed  Google Scholar 

  26. Pine DS, Cohen P, Gurley D, Brook J, Ma Y (1998) The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry 55:56–64

    Article  PubMed  CAS  Google Scholar 

  27. Reinecke MA, Ryan NE, DuBois DL (1998) Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis. J Am Acad Child Adolesc Psychiatry 37:26–34

    Article  PubMed  CAS  Google Scholar 

  28. Rembold CM (1998) Number needed to screen: development of a statistic for disease screening. BMJ 317:307–312

    PubMed  CAS  Google Scholar 

  29. Reynolds W, Coats K (1986) A comparison of cognitive-behavior therapy an relaxation training for the treatment of depression in adolescents. J Consult Clin Psychol 54:653–660

    Article  PubMed  CAS  Google Scholar 

  30. Roberts C, Kane R, Thomson H, Bishop B, Hart B (2003) The prevention of depressive symptoms in rural school children: a randomized controlled trial. J Consult Clin Psychol 71:622–628

    Article  PubMed  Google Scholar 

  31. Ryan ND (2005) Treatment of depression in children and adolescents. Lancet 366:933–940

    Article  PubMed  CAS  Google Scholar 

  32. Stark KD, Reynolds WM, Kaslow NJ (1987) A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children. J Abnorm Child Psychol 15:91–113

    Article  PubMed  CAS  Google Scholar 

  33. Weisz JR, Weiss B, Han SS, Granger DA, Morton T (1995) Effects of psychotherapy with children and adolescents revisited: a meta-analysis of treatment outcome studies. Psychol Bull 117:450–468

    Article  PubMed  CAS  Google Scholar 

  34. Weisz JR, Thurber CA, Sweeney L, Proffit VD, LeGagnoux GL (1997) Brief treatment of mild-to-moderate child depression using primary and secondary control enhancement training. J Consult Clin Psychol 65:703–707

    Article  PubMed  CAS  Google Scholar 

  35. Weisz JR, Hawley KM, Doss AJ, (2004) Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders. Child Adolesc Psychiatr Clin N Am 13:729–815

    Article  PubMed  Google Scholar 

  36. Yu DL, Seligman MEP (2002) Preventing depressive symptoms in Chinese children. Prev Treatm, Vol. 5 Webpage: http://www.journals.apa.org/prevention/volume5/toc-may08-02.htm

  37. Zwaanswijk M, Verhaak PF, Bensing JM, van der Ende J, Verhulst FC (2003) Help seeking for emotional and behavioural problems in children and adolescents: a review of recent literature. Eur Child Adolesc Psychiatry 12:153–161

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Clinical Psychology, Vrije Universiteit, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands

    Pim Cuijpers, Annemieke van Straten, Niels Smits & Filip Smit

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  1. Pim Cuijpers
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  2. Annemieke van Straten
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  3. Niels Smits
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  4. Filip Smit
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Correspondence to Pim Cuijpers.

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Cuijpers, P., van Straten, A., Smits, N. et al. Screening and early psychological intervention for depression in schools. Eur Child Adolesc Psychiatry 15, 300–307 (2006). https://doi.org/10.1007/s00787-006-0537-4

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