Depression Prevention Initiative - A Study of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) in School Settings

• Presence of a Major Depressive Episode, Dysthymia or Depressive Disorder Not Otherwise Specified (NOS) on the Schedule for Affective Disorders for School Aged Children - Present and Life Time Version (K-SADS-PL) [ Time Frame: Post intervention (approximately 3 months post baseline) ] [ Designated as safety issue: No ]
  Presence of a depression diagnosis as measured by a semi-structured diagnostic evaluation
• Presence of a Major Depressive Episode, Dysthymia or Depressive Disorder NOS on the K-SADS-PL [ Time Frame: 6-months post-intervention ] [ Designated as safety issue: No ]
• Presence of a Major Depressive Episode, Dysthymia or Depressive Disorder NOS on the K-SADS-PL [ Time Frame: 12-months post-intervention ] [ Designated as safety issue: No ]
• Presence of a Major Depressive Episode, Dysthymia or Depressive Disorder NOS on the K-SADS-PL [ Time Frame: 18-months post-intervention ] [ Designated as safety issue: No ]
• Presence of a Major Depressive Episode, Dysthymia or Depressive Disorder NOS on the K-SADS-PL [ Time Frame: 24-months post-intervention ] [ Designated as safety issue: No ]

• Children's Depression Rating Scale-Revised (CDRS-R) [ Time Frame: Post intervention (approximately 3 months after baseline) ] [ Designated as safety issue: No ]
  Scores on the CDRS-R
• Children's Depression Rating Scale-Revised [ Time Frame: 6-months post-intervention ] [ Designated as safety issue: No ]
• Children's Depression Rating Scale-Revised [ Time Frame: 12-months post-intervention ] [ Designated as safety issue: No ]
• Children's Depression Rating Scale-Revised [ Time Frame: 18-months post-intervention ] [ Designated as safety issue: No ]
• Children's Depression Rating Scale-Revised [ Time Frame: 24 months post-intervention ] [ Designated as safety issue: No ]
• Children's Global Assessment Scale (CGAS) [ Time Frame: Post intervention (approximately 3 months following baseline) ] [ Designated as safety issue: No ]
  Assesses global functioning
• Children's Global Assessment Scale [ Time Frame: 6-months post-intervention ] [ Designated as safety issue: No ]
• Children's Global Assessment Scale [ Time Frame: 12-months post-intervention ] [ Designated as safety issue: No ]
• Children's Global Assessment Scale [ Time Frame: 18-months post-intervention ] [ Designated as safety issue: No ]
• Children's Global Assessment Scale [ Time Frame: 24-months post-intervention ] [ Designated as safety issue: No ]

This study is a randomized controlled trial comparing Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) to group counseling (GC) for the prevention of depression in adolescents. The project will: (1) identify adolescents with elevated depressive symptoms but who do not meet criteria for a current mood disorder diagnosis; (2) randomize eligible adolescents to either IPT-AST (N = 100) or GC (N = 100); (3) assess depressive symptoms, depressive disorders, global functioning, interpersonal functioning, comorbid conditions and school related indices at baseline, mid-intervention, post-intervention, and at 6-, 12-, 18-, and 24-month follow-up; (4) examine the effects of IPT-AST on depression and various domains of functioning at each time point; and (5) conduct analyses to examine potential mediators and moderators of the association between IPT-AST and depression outcomes. This study will yield data on the efficacy of IPT-AST relative to GC for the prevention of depressive symptoms and depressive disorders. It will also provide information about the mechanisms of action of IPT-AST and determine for whom IPT-AST is most effective.

• Behavioral: IPT-AST
  A school-based group prevention program that includes 2 individual pre-group sessions, 8 weekly 90 minute group sessions, an individual mid-group session and 4 booster sessions
  Other Name: Interpersonal Psychotherapy-Adolescent Skills Training
• Behavioral: Group Counseling
  Usual group counseling as delivered by school counselors; 1 pre-group session, 1 mid-group session, 8 90-minute group sessions, 4 booster sessions
  Other Name: Usual group counseling

• Experimental: IPT-AST
  Interpersonal Psychotherapy-Adolescent Skills Training
  Intervention: Behavioral: IPT-AST
• Active Comparator: Group Counseling
  Group Counseling
  Intervention: Behavioral: Group Counseling

Inclusion Criteria:

• In 7th-10th grades at intake
• Center for Epidemiologic Studies Depression Scale(CES-D) Score > 16
• At least 2 symptoms on the K-SADS depression section (score of 2 or 3), one of which is either depressed mood, irritability, or anhedonia
• Adolescent must be English-speaking
• Parent speaks English or Spanish

Exclusion Criteria:

• CES-D Score < 15
• Fewer than 2 depression symptoms on the K-SADS (score of 2 or 3) or 2 or more symptoms on the K-SADS with no report of depressed mood, irritability, or anhedonia
• Suicide attempt or self-mutilation in the past year, current active suicidal ideation, and/or history of a clinically significant suicidal behavior (i.e., with intent to die and high medical lethality) or repeated patterns of self-injurious behavior
• Presence of current Major Depressive Disorder, dysthymia, substance abuse, schizophrenia, bipolar disorder, conduct disorder, or psychosis