Impact of Increasing Adolescent Depression Literacy on Treatment-Seeking Behavior

提高青少年抑郁素养对寻求治疗行为的影响

• 批准号: 8675948
• 负责人: Holly C Wilcox
• 金额: $ 44.81万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8675948
• 关键词: 19 year old; Address; Adolescence; Adolescent; Adult; Affect; Age; Anxiety Disorders; Autopsy; Awareness; Behavior; Bipolar Depression; Cessation of life; Characteristics; Communities; Community Mental Health Services; Comorbidity; Controlled Study; County; Development; Early identification; Early treatment; Education; Educational Curriculum; Effectiveness; Family; Family Relationship; Goals; Health; Health education; High School Student; Home environment; Hour; Human Resources; Impairment; Indian reservation; Intervention; Knowledge; Life; Major Depressive Disorder; Measures; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mission; Morbidity - disease rate; Nurse Psychotherapist; Oklahoma; Parents; Patient Self-Report; Pennsylvania; Prevalence; Prevention; Professional counselor; Psychiatric Nursing; Psychiatrist; Publishing; Randomized; Recurrence; Reporting; Research; Risk; Role; Schools; Social Work; Students; Substance Addiction; Suicide; Symptoms; Teenagers; Testing; Time; Training; Underachievement; Unemployment; Unipolar Depression; United States; United States Indian Health Service; United States Substance Abuse and Mental Health Services Administration; Universities; Visit; Work; Youth; base; child depression; depression education; depressive symptoms; design; disability; effective therapy; effectiveness trial; emerging adult; experience; help-seeking behavior; high school; high standard; improved; intervention program; literacy; medical schools; mortality; ninth grade; peer; post intervention; programs; psychologic; randomized trial; school health; single episode major depressive disorder; social; social stigma; teacher; universal prevention; young adult

DESCRIPTION (provided by applicant): This large-scale randomized school-based effectiveness trial will study whether the Adolescent Depression Awareness Program (ADAP), a program that has shown in one group pre-post and nonrandomized controlled studies to increase depression literacy among adolescents, has an impact on treatment-seeking behaviors. Depression is prevalent, costly and a major cause of disability and death worldwide. The onset of depression often occurs early in life, during teen or young adult years as 21-28 percent of adolescents experience an episode of major depression by the age of 19 years. The onset of depression during adolescence is associated with increased risk for Major depression during adulthood, substance dependence, educational underachievement, unemployment, and early parenthood. These difficulties are also often evident in adolescents with subclinical levels of depression. Depression has substantial continuity into adulthood with impaired functioning in work, social, and family life. The most severe consequence of untreated depression is suicide. Despite the high proportion of adolescents affected and disability associated with depression, there have been few large-scale school-based randomized trials investigating the effectiveness of universal interventions targeting depression among adolescents; and the results from these studies have been mixed. ADAP, a school-based depression education program developed in 1999 by a team of psychiatrists and psychiatric nurses from the Johns Hopkins University School of Medicine, has been implemented in 85 schools throughout the United States with over 20,000 ninth grade students. ADAP is delivered by school-personnel (trained health education teachers) as part of the standard high school health education curriculum. A randomized trial of the ADAP's effectiveness has not yet been conducted. We propose to assess the effectiveness of ADAP in increasing depression literacy and treatment seeking among adolescents in 66 schools (n=15,000) in five regions of the United States using a randomized, universal school-based effectiveness trial. We will also identify possible mediators and moderators of intervention impact (e.g., access to community mental health services, teacher characteristics, school characteristics, stigma, and fidelity).

描述（由申请人提供）：这项大规模随机、以学校为基础的有效性试验将研究青少年抑郁意识计划 (ADAP)，该计划在一组事前和非随机对照研究中显示，是否可以提高青少年对抑郁症的认识，对寻求治疗的行为有影响。抑郁症普遍存在，代价高昂，是全世界残疾和死亡的主要原因。抑郁症通常发生在生命早期，即青少年或青年时期，21-28% 的青少年在 19 岁时经历过重度抑郁症。青春期抑郁症的发病与成年期重度抑郁症、物质依赖、教育成绩不佳、失业和早为人父母的风险增加有关。这些困难在患有亚临床抑郁症的青少年中也常常很明显。抑郁症会持续到成年，导致工作、社交和家庭生活功能受损。未经治疗的抑郁症最严重的后果是自杀。尽管受影响的青少年和与抑郁症相关的残疾比例很高，但很少有大规模的以学校为基础的随机试验来调查针对青少年抑郁症的普遍干预措施的有效性；这些研究的结果好坏参半。 ADAP 是由约翰·霍普金斯大学医学院的精神科医生和精神科护士团队于 1999 年开发的一项校本抑郁症教育计划，已在美国 85 所学校、超过 20,000 名九年级学生中实施。 ADAP 由学校人员（经过培训的健康教育教师）教授，作为标准高中健康教育课程的一部分。尚未进行 ADAP 有效性的随机试验。我们建议使用一项随机、普遍的学校有效性试验来评估 ADAP 在提高美国五个地区 66 所学校 (n = 15,000) 青少年抑郁症认知和治疗寻求方面的有效性。我们还将确定干预影响的可能中介因素和调节因素（例如，获得社区心理健康服务、教师特征、学校特征、耻辱和忠诚度）。