Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2011

Open Access 01-12-2011 | Study protocol

School-based intervention to improve the mental health of low-income, secondary school students in Santiago, Chile (YPSA): study protocol for a randomized controlled trial

Authors: Ricardo Araya, Alan A Montgomery, Rosemarie Fritsch, David Gunnell, Paul Stallard, Sian Noble, Vania Martinez, Sergio Barroilhet, Paul Vohringer, Viviana Guajardo, Felix Cova, Jorge Gaete, Alejandro Gomez, Graciela Rojas

Published in: Trials | Issue 1/2011

Login to get access

Abstract

Background

Depression is common and can have devastating effects on the life of adolescents. Psychological interventions are the first-line for treating or preventing depression among adolescents. This proposal aims to evaluate a school-based, universal psychological intervention to reduce depressive symptoms among student's aged 13-14 attending municipal state secondary schools in Santiago, Chile.

Study design

This is a cluster randomised controlled trial with schools as the main clusters. We compared this intervention with a control group in a study involving 22 schools, 66 classes and approximately 2,600 students. Students in the active schools attended 11 weekly and 3 booster sessions of an intervention based on cognitive-behavioural models. The control schools received their usual but enhanced counselling sessions currently included in their curriculum. Mean depression scores and indicators of levels of functioning were assessed at 3 and 12 months after the completion of the intervention in order to assess the effectiveness of the intervention. Direct and indirect costs were measured in both groups to assess the cost-effectiveness of this intervention.

Discussion

As far as we are aware this is the first cluster randomised controlled trial of a school intervention for depression among adolescents outside the Western world.

Trial Registration

ISRCTN19466209
Literature
1.
The WHO World Mental Health Survey Consortium: Prevalence, Severity, and Unmet Need for Treatment of Mental Disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004, 291: 2581-2590. 10.1001/jama.291.21.2581.CrossRef
2.
Ormel J, von Korff M, Ustun B, Pini B, Korten A, Oldehinkel T: Common mental disorders and disability across cultures: results from the WHO collaborative study on psychological problems in general health care. Journal of the American Medical Association. 1994, 272: 1741-1748. 10.1001/jama.272.22.1741.CrossRefPubMed
3.
Araya R, Rojas G, Fritsch R, Acuna J, Lewis G: Common mental disorders in Santiago, Chile. Prevalence and socio-demographic correlates. British Journal of Psychiatry. 2001, 178: 228-233. 10.1192/bjp.178.3.228.CrossRefPubMed
4.
Almeida-Filho N, Mari J, Coutinho E, Franca J, Fernanades J, Andreoli S: Brazilian Multicentric study of psychiatric morbidity. British Journal of Psychiatry. 1997, 171: 524-529. 10.1192/bjp.171.6.524.CrossRefPubMed
5.
Canino G, Bird HR, Shrout PE: The Prevalence of Specific Psychiatric Disorders in Puerto Rico. Archives of General Psychiatry. 1987, 44: 727-735.CrossRefPubMed
6.
Duarte C, Hoven C, Berganza C, Bordin I, Bird H, Miranda CT: Child mental health in Latin America: Present and future epidemiologic research. International Journal of Psychiatry in Medicine. 2003, 33: 203-222. 10.2190/4WJB-BW16-2TGE-565W.CrossRefPubMed
7.
Fleitlich-Blyck B, Goodman R: Social factors associated with child mental health problems in Brazil: cross sectional survey. BMJ. 2001, 323: 599-600. 10.1136/bmj.323.7313.599.CrossRef
8.
Fergusson DM, Woodward LJ: Mental health, educational, and social role outcomes of adolescents with depression. Archives of General Psychiatry. 2002, 59: 225-231. 10.1001/archpsyc.59.3.225.CrossRefPubMed
9.
Pine DS, Cohen E, Cohen P, Book J: Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder?. American Journal of Psychiatry. 1999, 156: 133-135.CrossRefPubMed
10.
Stein MB, Fuetsch M, Muller N, Hofler M, Lieb R, Wittchen H: Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Archives of General Psychiatry. 2001, 58: 251-256. 10.1001/archpsyc.58.3.251.CrossRefPubMed
11.
Gotlib IH, Lewinsohn PM, Seeley J: Symptoms versus a diagnosis of depression: Differences in psychosocial functioning. Journal of Consulting and Clinical Psychology. 1995, 63: 90-100. 10.1037/0022-006X.63.1.90.CrossRefPubMed
12.
Lewinsohn PM, Solomon A, Seeley J, Zeiss A: Clinical implications of 'subthreshold' depressive symptoms. Journal of Abnormal Psychology. 2000, 109: 345-351. 10.1037/0021-843X.109.2.345.CrossRefPubMed
13.
Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE: Childhood and adolescent depression: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry. 1996, 35: 1427-1439.CrossRef
14.
National Institute for Clinical Excellence (NICE): Suggested actions for implementing the NICE clinical guideline on depression in children and young people. Department of Health. 2005, London, DoH
15.
Compton SN, March JS, Brent D, Albano AM, Weersing R, Curry J: Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. J Am Acad Child Adolesc Psychiatry. 2004, 43: 930-959. 10.1097/01.chi.0000127589.57468.bf.CrossRefPubMed
16.
Harrington R, Whittaker J, Shoebridge P, Campbell F: Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ. 1998, 316: 1559-1563.CrossRefPubMedPubMedCentral
17.
Mufson L, Pollack Dorta K, Wickramaratne P, Nomura Y, Olfson M, Weissman M: A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry. 2004, 61: 577-584. 10.1001/archpsyc.61.6.577.CrossRefPubMed
18.
Rosello J, Bernal G: The efficacy of Cognitive-Behavioral and Interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting and Clinical Psychology. 1999, 67: 734-745. 10.1037/0022-006X.67.5.734.CrossRef
19.
Lewinsohn PM, Clarke GN, Seeley J, Rhode P: Major depression in community adolescents: Age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry. 1994, 33: 809-818. 10.1097/00004583-199407000-00006.CrossRefPubMed
20.
Mrazek PJ, Haggerty RJ: Reducing risks for mental disorders: Frontiers for preventive intervention research. 1994, Washington DC: National Academy Press
21.
Merry S, McDowell HM, Hetrick S, Muller N: Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database of Systematic Reviews. 2004, 2:
22.
Shochet IM, Dadds MR, Holland D, Whitefield K, Harnett PH, Osgarby SM: The efficacy of a universal school-based program to prevent adolescent depression. J Clin Child Adolesc Psychol. 2001, 30: 303-315. 10.1207/S15374424JCCP3003_3.CrossRef
23.
Spence SH, Sheffield JK, Donovan CL: Preventing adolescent depression. An evaluation of the Problem Solving for Life program. J Consult Clin Psychol. 2003, 71: 3-13. 10.1037/0022-006X.71.1.3.CrossRefPubMed
24.
Possel P, Baldus C, Horn AB, Groen G, Hautzinger M: Influence of general self-efficacy on the effects of a school-based universal primary prevention program of depressive symtpoms in adolescents: a randomized and controlled follow-up study. Journal of Child Psychology and Psychiatry. 2005, 46: 982-994. 10.1111/j.1469-7610.2004.00395.x.CrossRefPubMed
25.
Merry S, McDowell HM, Wild CJ, Bir J, Cunliffe R: A randomized placebo-controlled trial of a school based depression prevention program. Journal of American Academy of Child and Adolescent Psychaitry. 2004, 43: 538-547. 10.1097/00004583-200405000-00007.CrossRef
26.
Sheffield JK, Spence SH, Rapee RM, Wignall A, Davis A: Evaluation of universal, indicated, and combined cognitive-behavioral approaches to the prevention of depression among adolescents. Journal of Consulting and Clinical Psychology. 2006, 74: 66-79. 10.1037/0022-006X.74.1.66.CrossRefPubMed
27.
Spence SH, Sheffield JK, Donovan CL: Long-term outcome of a school-based, universal approach to prevention of depression in adolescents. Journal of Consulting and Clinical Psychology. 2005, 73: 160-167. 10.1037/0022-006X.73.1.160.CrossRefPubMed
28.
Clarke GN, Hawkins W, Murphy M, Sheeber L: School-based primary prevention of depressive symptomatology in adolescents: Findings from two studies. Journal of Adolescent Research. 1993, 8: 183-204. 10.1177/074355489382004.CrossRef
29.
Gillham JE, Reivich KJ, Jaycock LH, Seligman M: Prevention of depressive symptoms in schoolchildren: Two-year follow-up. Psychological Science. 1995, 6: 343-351. 10.1111/j.1467-9280.1995.tb00524.x.CrossRef
30.
Rapee RM, Wignall A, Sheffield J, Kowalenko N, Davis A, McLoone J: Adolescents' reactions to universal and indicated prevention programs for depression: Perceived stigma and consumer satisfaction. Prevention Science. 2006, 7: 167-177. 10.1007/s11121-006-0035-4.CrossRefPubMed
31.
Post RM, Weiss SR: Sensitization and kindling phenomena in mood, anxiety, and obsessive-compulsive disorders: the role of serotoninergic mechanisms in illness progression. Biological Psychiatry. 1998, 44: 193-206. 10.1016/S0006-3223(98)00144-9.CrossRefPubMed
32.
Munoz RF, Ying Y-W: The prevention of depression. 1993, London: The John Hopkins University Press
33.
World Bank: World Development Report 2000/2001. Attacking Poverty. 2001, New York: Oxford University Press
34.
Ministerio de Salud: Las Enfermedades Mentales en Chile: Magnitud y Consecuencias. 1999, Santiago, Chile: Ministerio de Salud
35.
Araya R, Rojas G, Fritsch R, Frank R, Lewis G: Inequities in mental health care after health care system reform in Chile. Am J Public Health. 2006, 96: 109-113. 10.2105/AJPH.2004.055715.CrossRefPubMedPubMedCentral
36.
Ministerio de Planificacion Nacional: Encuesta de Caracterizacion Socioeconomica Nacional. 2003, Chile: MIDEPLAN
37.
Araya R, Rojas G, Fritsch R, Gaete J, Rojas M, Simon G: Treating depression in primary care in low-income women in Santiago, Chile. Lancet. 2003, 361: 995-1000. 10.1016/S0140-6736(03)12825-5.CrossRefPubMed
38.
Araya R, Flynn T, Rojas G, Fritsch R, Simon G: Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago, Chile. Am J Psychiatry. 2006, 163: 1379-1387. 10.1176/appi.ajp.163.8.1379.CrossRefPubMed
39.
Rojas G, Fritsch R, Solis J, Jadresic E, Castillo C, Gonzalez M: Treatment of postnatal depression in low-income mothers in primary-care clinics in Santiago, Chile: a randomised controlled trial. Lancet. 2007, 370: 1629-1637. 10.1016/S0140-6736(07)61685-7.CrossRefPubMed
40.
Araya R, Alvarado R, Minoletti A: Chile: an ongoing mental health revolution. Lancet. 2009, 374: 597-598. 10.1016/S0140-6736(09)61490-2.CrossRefPubMed
41.
Ministerio de Educacion: Indicadores de la Educacion en Chile 2002. 2002, Chile, Ministerio de Educacion
42.
Raab GM, Butcher I: Balance in cluster randomized trials. Statistics in Medicine. 2001, 20: 351-365. 10.1002/1097-0258(20010215)20:3<351::AID-SIM797>3.0.CO;2-C.CrossRefPubMed
43.
Beck AT, Steer RA, Brown G: BDI-II Beck Depression Inventory. 1996, San Antonio: The Psychological Corporation, Harcourt Brace & Company, 2
44.
Cumsille P, Martinez ML: Symptoms of depression among high school adolescents. Rev Chil Pediatria. 1997, 68: 74-77.
45.
Bonilla J, Bernal G, Santos A, Santos D: A Revised Spanish Version of the Beck Depression Inventory: Psychometric Properties with a Puerto Rican Sample of College Students. Journal of Clinical Psychology. 2004, 60: 119-130. 10.1002/jclp.10195.CrossRefPubMed
46.
Novy D, Stanley MA, Averill P, Daza P: Psychometric Comparability of English- and Spanish-Language Measures of Anxiety and Related Affective Symptoms. Psychological Assessment. 2001, 13: 347-355. 10.1037/1040-3590.13.3.347.CrossRefPubMed
47.
Spence SH: A measure of anxiety symptoms among children. Behav Res Ther. 1998, 36: 545-566. 10.1016/S0005-7967(98)00034-5.CrossRefPubMed
48.
Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE: Assessment of symptoms of DSM IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy. 2000, 38: 835-855. 10.1016/S0005-7967(99)00130-8.CrossRefPubMed
49.
Muir Gray J: Evidence-based Healthcare. How to Make Health Policy and Management Decisions. 1997, New York: Churchill Livingstone
50.
Schniering CA, Rapee RM: Development and validation of a measure of children's automatic thoughts: the children's automatic thoughts scale. Behav Res Ther. 2002, 40: 1091-1109. 10.1016/S0005-7967(02)00022-0.CrossRefPubMed
51.
Schniering CA, Rapee RM: The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis. J Abnorm Psychol. 2004, 113: 464-470. 10.1037/0021-843X.113.3.464.CrossRefPubMed
52.
Schniering CA, Lyneham HJ: The Children's Automatic Thoughts Scale in a clinical sample: psychometric properties and clinical utility. Behav Res Ther. 2007, 45: 1931-1940. 10.1016/j.brat.2006.09.009.CrossRefPubMed
53.
D'Zurilla TJ, Nezu AM, Maydeu-Olivares A: Manual for the Social Problem-Solving Inventory Revised (SPSI-R). 1998, New York: Multi-Health Systems, Inc
54.
Calvete E, Cardenoso O: Gender Differences in Cognitive Vulnerability to Depression and Behavior Problems in Adolescents. Journal of Abnormal Psychology. 2005, 33 (2): 179-192.CrossRef
55.
Calvete E, Cardenoso O: Creencias, Resolución de Problemas Sociales y Correlatos Psicológicos. Psicothema. 2001, 13 (1): 95-100.
56.
Rose G: The strategy of preventive medicine. 1993, Oxford: Oxford University Press
57.
Eldrige SM, Ashby D, Kerry S: Sample size for cluster randomized trials: effect of coefficient of variation of cluster size and analysis method. International Journal of Epidemiology. 2006, 35 (5): 1292-1300. 10.1093/ije/dyl129.CrossRef
Metadata
Title
School-based intervention to improve the mental health of low-income, secondary school students in Santiago, Chile (YPSA): study protocol for a randomized controlled trial
Authors
Ricardo Araya
Alan A Montgomery
Rosemarie Fritsch
David Gunnell
Paul Stallard
Sian Noble
Vania Martinez
Sergio Barroilhet
Paul Vohringer
Viviana Guajardo
Felix Cova
Jorge Gaete
Alejandro Gomez
Graciela Rojas
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Trials / Issue 1/2011
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-12-49

Other articles of this Issue 1/2011

Trials 1/2011 Go to the issue

Research

Effects on patients of their healthcare practitioner's or institution's participation in clinical trials: a systematic review

Research

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

Study protocol

Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

Study protocol

Randomised social-skills training and parental training plus standard treatment versus standard treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol

Study protocol

Strategic use of new generation antidepressants for depression: SUN(^_^)D study protocol

Study protocol

Panax ginseng C.A Meyer root extract for moderate Chronic Obstructive Pulmonary Disease (COPD): study protocol for a randomised controlled trial