Help for teens and families at-risk for depression

New research reveals that a cognitive behavioral program for teens at risk of depression may help prevent future depressive episodes. However, the program did not show benefits for teens with a currently depressed parent.

The research by Judy Garber, professor of psychology at Peabody and professor of psychiatry, was published in the June 3 issue of the Journal of the American Medical Association. Garber presented the findings at a JAMA media briefing in New York City June 2.

Garber
Garber

Garber and her colleagues worked with 316 at-risk teens in the study. Approximately half of the teens were randomly assigned to an eight-week cognitive behavior group program in which they were taught problem-solving skills and ways to identify and challenge unrealistic and overly negative thoughts. The researchers found that the group in the cognitive behavior program had an 11 percent lower incidence of depression than the group that did not receive the intervention.

The second key finding was that those within the cognitive behavior group who had a currently depressed parent were three times more likely to experience a bout of depression than their cohorts in the group who did not have a currently depressed parent.

“Current parental depression could be a marker for several, non-mutually exclusive factors such as higher levels of stress in the family, more chronic or severe parental depression, and/or greater genetic vulnerability,” Garber said. “It is likely that a combination of these and other factors are involved. We are in the process of examining possible correlates of current parental depression.”

Garber and her colleagues suggest clinicians working with depressed parents should also inquire about their children’s well-being, and vice versa.

Only about 25 percent of depressed youth receive treatment and at least 20 percent develop recurrent, persistent and chronic depression that is very difficult to treat. Teenagers who experience depressions can have trouble with schoolwork, relationships, substance abuses and are at higher risk of suicide. Adolescent-onset depression also often predicts chronic depression in adulthood.

Garber is an investigator in the Vanderbilt Kennedy Center for Research on Human Development.

A related report from the National Research Council and Institute of Medicine argues that health and social service professionals who care for adults with depression should not only tackle their clients’ physical and mental health but also detect and prevent possible spillover effects on their children. To achieve this new family-focused model of depression care, federal and state agencies, nonprofits and the private sector will have to experiment with nontraditional ways of organizing, paying for and delivering services, the committee that wrote the report said.

Compas
Compas

“This report is designed to place the problem of depression and its effects on parents and children on the national health care agenda,” said report co-author Bruce Compas, Patricia and Rodes Hart Professor of Psychology and Human Development at Peabody. “The report summarizes research that documents the adverse effects of parental depression on children’s mental health and outlines an agenda for research and health care services for the prevention of mental health problems in children of parents with depression.”

Emerging evidence for effective preventive interventions is highlighted, including two separate preventive interventions for children of depressed parents tested in randomized clinical trials supported by the National Institute of Mental Health and conducted at Peabody College and other locations (one of which is Garber’s study mentioned above).

Major depressive disorder affects 16 percent of Americans in their lifetime, and young parents are at particularly high risk.

It is estimated that 7.5 million parents in the U.S. suffer from depression, affecting more than 15 million children who live with these parents.

Children of depressed parents are at four times greater risk to develop depression and as many as 75 percent of these children develop some form of mental health problem. Effective tools and strategies exist to treat and prevent depression, but only one-third of adult sufferers get treatment.

For more information on Garber’s research: www.jamamedia.org.
Full report by NRC: www.iom.edu/?ID=69567