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Randomized Controlled Trial
. 2019 May 22;19(1):155.
doi: 10.1186/s12888-019-2134-3.

Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course

Thormod Idsoe  1 , Serap Keles  2 , Asgeir Røyrhus Olseth  2 , Terje Ogden  2
Affiliations
Randomized Controlled Trial

Cognitive behavioral treatment for depressed adolescents: results from a cluster randomized controlled trial of a group course

Thormod Idsoe et al. BMC Psychiatry. .

Abstract

Background: The group-based CBT intervention, the Adolescent Coping with Depression Course (ACDC), has previously been evaluated within a quasi-experimental design, showing reduction in depressive symptoms compared to a benchmark of similar studies. The aim of our study was to investigate the effectiveness of ACDC within a randomized controlled (RCT) design.

Method: Thirty-five course/control leaders randomly assigned to provide ACDC or usual care (UC) recruited 133 adolescents allocated to ACDC and 95 to UC. ACDC participants received eight weekly sessions and two follow-up sessions about 3 and 6 weeks after the last session. UC participants received usual care as implemented at the different sites. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale for adolescents (CES-D), perfectionism with the revised version of the Dysfunctional Attitude Scale (DAS), and rumination with the revised version of the Ruminative Responses Scale (RRS). Attrition was considered missing at random (MAR) and handled with a full information maximum likelihood (FIML) procedure.

Results: Intention to treat analysis (ITT), including baseline scores and predictors of missing data as control or auxiliary variables, showed a small to medium reduction in depressive symptoms for the ACDC group compared to UC (d = -.31). Changes in perfectionism and rumination in favor of the intervention were also significant. Sensitivity analyses confirmed the findings from the ITT analyses.

Conclusions: The current study supports the effectiveness of this group-based CBT intervention. The intervention can hopefully result in clinically significant reductions in symptoms associated with depression among adolescents.

Trial registration: ISRCTN registry ISRCTN19700389 . Registered 6 October 2015.

Keywords: Adolescents; Depression; Group-CBT; Randomized controlled trial.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Participants flowchart
Fig. 2
Fig. 2
Path diagram of the longitudinal effect of the intervention on depression at post-test. Gender = Males are coded as 1 and females as 2. Intervention = UC control was coded as 0 and. ACDC intervention as 1. Unstandardized parameter estimates are reported only for the . significant paths from the covariates. *p < .05, ***p < .001
Fig. 3
Fig. 3
Slopes of improvement in the ACDC and UC groups
See this image and copyright information in PMC

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