TARGETED PREVENTION OF UNIPOLAR DEPRESSIVE DISORDER IN AN AT-RISK SAMPLE OF HIGH-SCHOOL ADOLESCENTS - A RANDOMIZED TRIAL OF GROUP COGNITIVEINTERVENTION

Objectives: This investigation attempted to prevent unipolar depressiv e episodes in a sample of high school adolescents with an elevated ris k of depressive disorder. Method: Adolescents at risk for future depre ssive disorder by virtue of having elevated depressive symptomatology were selected with a two-stage case-finding procedure. The Center for Epidemiologic Studies-Depression Scale (CES-D) was administered to 1,6 52 students; adolescents with elevated CES-D scores were interviewed w ith the Schedule for Affective Disorders and Schizophrenia for School- Age Children. Subjects with current affective diagnoses were referred to nonexperimental services. The remaining 150 consenting subjects wer e considered at risk for future depression and randomized to either a 15-session cognitive group prevention intervention or an ''usual care' ' control condition. Subjects were reassessed for DSM-III-R diagnostic status after the intervention and at 6- and 12-month follow-up points . Results: Survival analyses indicated a significant 12-month advantag e for the prevention program, with affective disorder total incidence rates of 14.5% for the active intervention, versus 25.7% for the contr ol condition. No differences were detected for nonaffective disorders across the study period. Conclusion: Depressive disorder can be succes sfully prevented among adolescents with an elevated future risk.