Enduring effects of a five-week behavioral activation program for subthreshold depression among late adolescents: an exploratory randomized controlled trial
Received 28 April 2018
Accepted for publication 23 July 2018
Published 9 October 2018 Volume 2018:14 Pages 2633—2641
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Taro Kishi
Koki Takagaki,1 Yasumasa Okamoto,2 Ran Jinnin,2 Asako Mori,2 Yoshiko Nishiyama,3 Takanao Yamamura,4 Satoshi Yokoyama,2 Syouichi Shiota,5,6 Yuri Okamoto,1 Yoshie Miyake,1 Akiko Ogata,7 Yoshihiko Kunisato,8 Haruki Shimoda,9 Norito Kawakami,10 Toshi A Furukawa,11 Shigeto Yamawaki2
1Health Service Center, Hiroshima, Japan; 2Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan; 3Haruma City Office, Haruma, Japan; 4Kanazawa University Hospital Neuropsychiatry, Kanazawa, Japan; 5Japan Society for the Promotion of Science, Tokyo, Japan; 6Department of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan; 7Department of Psychology, Hiroshima University, Hiroshima, Japan; 8Department of Psychology, School of Human Sciences, Senshu University, Kawasaki, Japan; 9Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan; 10Department of Psychiatry of Mental Health, The University of Tokyo, Tokyo, Japan; 11Department of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public health, Kyoto, Japan
Background: No significant effect of psychological treatment has been reported from meta-analysis of subthreshold depression patients and control subjects at 1-year follow-up. However, behavioral activation is a simpler and more cost-effective treatment than cognitive behavioral therapy. The primary purpose of this study was to assess by comparison to an assessment-only control group whether the effects of behavioral activation program for depressive symptoms can persist up to 1-year follow-up without the use of antidepressants or other psychotherapy.
Patients and methods: Late adolescent students were the population targeted in this study. Participants were allocated randomly to an intervention group (n=62) or a control group (n=56). Treatment consisted of five-weekly 60-minute sessions. Participants underwent a structured interview and completed self-report scales at 1 year post-assessment.
Results: Late adolescent students receiving treatment had significantly lower mean Beck Depression Inventory, second edition scores at 1-year follow-up than control group students. The effect size (Hedges’ g) for between-group differences at 1-year follow-up was -0.41.
Conclusion: Our behavioral activation program is simple and short. Nevertheless, the results obtained at 1-year follow-up of the control group and late adolescent students receiving treatment indicated a significant difference in their Beck Depression Inventory, second edition scores. Our 5-week behavioral activation program based on behavioral characteristics for subthreshold depression might be promising for subthreshold depression. The sample examined for this study imposed some study limitations.
Keywords: behavioral activation, first-year university students, randomized controlled trial, subthreshold depression
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