Preventing depression in secondary school pupils

Helen Christensen and colleagues conducted a cluster randomised trial to investigate the effectiveness of an intervention for the prevention of depression in secondary school pupils.

The study, published in the Journal of Medical Internet Research, reported on the results of a trial of the SPARX-R programme, a gamified online cognitive behaviour intervention that is delivered to pupils prior to facing a significant stressor – in this case final secondary school exams.

A total of 540 final-year pupils from 10 secondary schools in Sydney, Australia, took part and clusters at the school level were randomly allocated to SPARX-R or the control intervention (lifeSTYLE, an online interactive control programme). Interventions were delivered weekly in class under teacher supervision, in seven 20- to 30-minute modules. Symptoms of depression were measured by the Major Depression Inventory (MDI).

Pupils in the SPARX-R group showed a greater reduction in MDI scores than those in the control group, both post-intervention and at the 6-month follow-up. Effect sizes were small post-intervention (+0.29) and at the 6-month (+0.21) and 18-month follow-ups (+0.33).

Source: Preventing depression in final year secondary students: school-based randomized controlled trial (November 2017), Journal of Medical Internet Research, vol 19 (11).

A little help from FRIENDS

A new article in The Lancet Psychiatry investigates the effect of a classroom-based cognitive behaviour therapy programme called FRIENDS on anxiety symptoms in children.
The authors conducted a three-group cluster randomised controlled trial. A total of 45 primary schools in southwest England were recruited into the trial, which took place in the 2011/2012 school year. Pupils aged 9 and 10 (n=497) were randomly assigned to receive either school-led FRIENDS (led by a teacher or school staff member), health-led FRIENDS (led by two trained health facilitators), or their usual school provision. Outcomes were collected by a self-completed questionnaire.

The authors found that training teachers to deliver the programme was not as effective as delivery by health professionals. After 12 months, there were significant improvements in the children’s self-reported low mood and anxiety for those that had received the health-led intervention compared to the school-led approach. However, the school-led approach was more effective than normal provision.

The report concludes that universally delivered anxiety prevention programmes can be effective when used in schools. However, programme effectiveness varies depending on who delivers them.

Source: Classroom-based Cognitive Behaviour Therapy (FRIENDS): A Cluster Randomised Controlled Trial to Prevent Anxiety in Children through Education in Schools (PACES) (2014), The Lancet Psychiatry, 1(3).