Depression is common among adolescents worldwide, affecting an estimated 4–5 percent of adolescents each year. It can lead to serious social and educational difficulties and is also a major risk factor for suicide. Despite effective treatments, only about one in four youth with depression receive treatment. Often the depression is quite severe before they get treatment.

There are effective ways to prevent youth depression, yet few at-risk youths have access to prevention services. A recent study from a team of researchers from Kaiser Permanente Northwest in Portland, Ore., Harvard University and several other universities looked at the cost-effectiveness of cognitive-behavioral prevention program in preventing depression among at-risk youth.

The study, published online in Psychiatric Services last week, involved 316 youth age 13-17 at high risk for depression. All had some depression symptoms, but did not meet the criteria for a diagnosis of major depression (subsyndromal depression) or had experienced a prior depressive episode that had been in full remission for at least 2 months or both. All of the participants had a parent with current or prior depression. The study did not include youth currently taking antidepressant medication or if they had received more than eight sessions of cognitive behavior therapy for depression.

The cognitive behavior prevention program consisted of 90-minute sessions once a week for eight weeks followed by six monthly continuation sessions. The program taught the youth problem-solving skills and how to identify and change troubling thoughts and beliefs. All of the participants were able to seek mental health services if needed. The youth in the cognitive behavioral prevention program had better outcomes than the control group. They experienced fewer depression episodes and had significantly more depression-free days at 9 months and 2 years after the intervention. The authors also found the program cost-effective at just under $600 per youth.

The authors recognize that few health systems provide mental health prevention services, but they suggest there is a growing awareness of the connection between depression and long-term health. Effective depression prevention programs, the authors argue, “could improve both short- and long-term health of youths and a reasonable cost.”