Feasibility and effectiveness of an Internet-based program for the prevention and early intervention of depression inInternet adolescents

Authors

  • Daniel Espinosa-Duque Universidad CES https://orcid.org/0000-0002-5378-2603
  • Mauricio Fernandez Universidad de Antioquia https://orcid.org/0000-0002-2274-2895
  • María Paula Ruiz Universidad CES
  • Juan Carlos Jaramillo Universidad CES
  • Markus Moessner Hospital Universitario de Heidelberg
  • Stephanie Bauer Hospital Universitario de Heidelberg
  • Mariane Krause Pontificia Universidad Católica de Chile

DOI:

https://doi.org/10.21615/cesp.5428

Keywords:

depression, adolescence, prevention, early intervention, Internet-based interventions, online program, E-Health

Abstract

Background: the high prevalence of depression in adolescence and its serious consequences, associated with its lack of detection and treatment, stimulate interest in research regarding its early prevention and intervention. Interventions based on information and communication technologies (ICT), given their flexibility and capacity for dissemination, represent innovative opportunities; however, in Latin America there is little evidence on their impact and efficacy. Objective and Methods: a quasi-experimental quantitative pilot study was carried out to evaluate the feasibility, through the variables of use and acceptability, and the estimated effect of the Internet-based program "Cuida tu Ánimo", in 215 adolescents (103 active group, 112 control group) from two educational institutions. The adolescents' interactions with the program, its use-acceptability, and the level of depressive symptomatology and other related aspects were evaluated. Results: the adolescents report high acceptance and very moderate use of the Program. They point out that the program allowed them to learn about depression and early detection of risk; also, they recommend increasing the interactivity of the web platform, designing more diverse and entertaining content, and increasing the presence of the intervention. Conclusions: Internet-based programs such as Cuida tu Ánimo can be a favorable complement for the prevention and early intervention of depression in adolescents. Considering the difficulty in relating the estimation of the Program's effect with its use, it is recommended that future studies include a design that permits associating the use indicators with the outcome indicators (dose-effect).

Downloads

Download data is not yet available.

Author Biographies

Daniel Espinosa-Duque, Universidad CES

Doctor en Psicoterapia. Docente Investigador Universidad CES, Colombia. 

Mauricio Fernandez, Universidad de Antioquia

Doctor en Psicopatología Fundamental y Psicoanálisis, Docente-investigador Universidad de Antioquia, Colombia.

María Paula Ruiz, Universidad CES

Psicóloga Universidad CES, Colombia. 

Juan Carlos Jaramillo, Universidad CES

Doctor en Psicologia. Docente-investigador Facultad de Psicología, Universidad CES, Colombia. 

Markus Moessner, Hospital Universitario de Heidelberg

Doctor. Centro de Investigación en Psicoterapia, Hospital Universitario, Heidelberg, Alemania.

Stephanie Bauer, Hospital Universitario de Heidelberg

Doctora en Psicología. Hospital Universitario de Heidelberg, Alemania. 

Mariane Krause, Pontificia Universidad Católica de Chile

Doctora en Psicología. Profesora Pontificia Universidad Católica de Chile. Investigadora Instituto Milenio para la Investigación en Depresión y Personalidad, MIDAP. 

References

Ayuso-Mateos, J. L., Nuevo, R., Verdes, E., Naidoo, N., & Chatterji S. (2010). From depressive symptoms to depressive disorders: the relevance of thresholds. The British Journal of Psychiatry, 196(5), 365-371. https://doi.org/10.1192/bjp.bp.109.071191

Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008). A comprehensive review and a metaanalysis of the effectiveness of Internet based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2-4), 109-160. https://doi.org/10.1080/15228830802094429

Barney, L., Griffiths, K., Christensen, H., & Jorm, A. (2010). The Self Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument. International Journal of Methods in Psychiatric Research, 19(4), 243-254. https://doi.org/10.1002/mpr.325

Bauer, S., Papezova, H., Chereches, R., Caselli, G., McLoughlin, O., Szumska, I., … Moessner, M. (2013). Advances in the prevention and early intervention of eating disorders: The potential of Internet delivered approaches. Mental Health & Prevention, 1(1), 26-32. https://doi.org/10.1016/j.mhp.2013.10.003

Calear, A., & Christensen, H. (2010). Review of internet‐based prevention and treatment programs for anxiety and depression in children and adolescents. Medical Journal of Australia, 192(11), S12-S14. https://doi.org/10.5694/j.1326-5377.2010.tb03686.x

Calear, A., Christensen, H., Mackinnon, A., Griffiths, K., & O'Kearney, R. (2009). The Youth Mood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents, Journal of Consulting and Clinical Psychology, 77(6), 1021-1032. https://doi.org/10.1037/a0017391

Camargo, L., Herrera-Pino, J., Shelach, S., Soto-Añari, M., Porto, M., Alonso, M., … López, N. (2021). Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad. Revista Colombiana de Psiquiatría. 50(2), 1-6. https://doi.org/10.1016/j.rcp.2021.06.003

Cassiani, C., & Scoppetta, O. (2018). Factorial structure of the Patient Health Questionnaire-9 as a depression screening instrument for university students in Cartagena, Colombia. Psychiatry research, 269(1), 425-429. https://doi.org/10.1016/j.psychres.2018.08.071

Christensen, H., Griffiths, K., & Korten, A. (2002). Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores. Journal of medical Internet research, 4(1), 1-9. https://doi.org/10.2196/jmir.4.1.e3

Clarke, G., Eubanks, D., Reid, E., Kelleher, C., O'connor, E., DeBar, L., … Gullion, C. (2005). Overcoming Depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. Journal of medical Internet research, 7(2), 1-12. https://doi.org/10.2196/jmir.7.2.e16

Domínguez, A., Aguilera, S., Acosta, T., Navarro, G., & Ruiz, Z. (2012). La deseabilidad social revalorada: más que una distorsión, una necesidad de aprobación social. Acta de investigación psicológica, 2(3), 808-824. https://doi.org/10.22201/fpsi.20074719e.2012.3.236

Espinosa, H., Carrasco, Á., Moessner, M., Cáceres, C., Gloger, S., Rojas, G., … Krause, M. (2016). Acceptability study of “Ascenso”: an online program for monitoring and supporting patients with depression in Chile. Telemedicine and e-Health, 22(7), 577-583. https://doi.org/10.1089/tmj.2015.0124

Gerrits, R., van der Zanden, R., Visscher, R., & Conijn, B. (2007). Master your mood online: A preventative chat group intervention for adolescents. Australian e-Journal for the Advancement of Mental Health, 6(3), 152-162. https://doi.org/10.5172/jamh.6.3.152

Grist, R., Croker, A., Denne, M., & Stallard, P. (2019). Technology delivered interventions for depression and anxiety in children and adolescents: a systematic review and meta-analysis. Clinical Child and Family Psychology Review, 22(2), 147-171. https://doi.org/10.1007/s10567-018-0271-8

Hoek, W., Marko, M., Fogel, J., Schuurmans, J., Gladstone, T., Bradford, N., … Van Voorhees, B. (2011). Randomized controlled trial of primary care physician motivational interviewing versus brief advice to engage adolescents with an Internet based depression prevention intervention: 6month outcomes and predictors of improvement. Translational Research, 158(6), 315-325. https://doi.org/10.1016/j.trsl.2011.07.006

Hoek, W., Schuurmans, J., Koot, H., & Cuijpers, P. (2009). Prevention of depression and anxiety in adolescents: a randomized controlled trial testing the efficacy and mechanisms of Internet-based self-help problem-solving therapy. Trials, 10(1), 1-13. https://doi.org/10.1186/1745-6215-10-93

Hoffmann, M., Rojas, G., & Martínez, V. (2014). Prevención, detección, tratamiento o seguimiento en salud mental de adolescentes a través del uso de Internet: una revisión sistemática cualitativa. Revista Médica de Chile, 142(4), 494-500. http://dx.doi.org/10.4067/S0034-98872014000400011

Horowitz, J., & Garber, J. (2006). The prevention of depressive symptoms in children and adolescents: a metaanalytic review. Journal of Consulting and Clinical Psycholy, 74(3), 401-415. https://doi.org/10.1037/0022-006X.74.3.401

Kessler. R., & Bromet, E. (2013). The epidemiology of depression across cultures. Annu Rev Public Health, 34(1), 119-138. https://doi.org/10.1146/annurev-publhealth-031912-114409

Kidscreen Group Europe. (2006). The Kidscreen questionnaires - Quality of life questionnaires for children and adolescents - Handbook. Pabst Science Publisher.

Konac, D., Young, K., Lau, J., & Barker, E. (2021). Comorbidity between depression and anxiety in adolescents: Bridge symptoms and relevance of risk and protective factors. Journal of psychopathology and behavioral assessment, 43(3), 583-596. https://doi.org/10.1007/s10862-021-09880-5

Latalova, K., Kamaradova, D., & Prasko, J. (2014). Perspectives on perceived stigma and self-stigma in adult male patients with depression. Neuropsychiatric disease and treatment, 10(1), 1399–1405. https://doi.org/10.2147/NDT.S54081

Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD7) in the general population. Medical Care. 46(3), 266-274. https://doi.org/10.1097/mlr.0b013e318160d093

Martínez, V., Crockett, M., Jiménez, Á., Espinosa, H., Barrientos, E., & Ordóñez, J. (2020). Stigmatizing beliefs and attitudes to depression in adolescent school students in Chile and Colombia. Frontiers in Psychology, 11(1), 1-10. https://doi.org/10.3389/fpsyg.2020.577177

Martínez, V., Martínez, P., Vöhringer, P., Araya, R., & Rojas, G. (2014). Computer-assisted cognitive-behavioral therapy for adolescent depression in primary care clinics in Santiago, Chile (YPSAM): study protocol for a randomized controlled trial. Trials, 15(1), 1-6. https://doi.org/10.1186/1745-6215-15-309

Martínez, P., Rojas, G., Martínez, V., Lara, M., & Pérez, J. (2018). Internet-based interventions for the prevention and treatment of depression in people living in developing countries: A systematic review. Journal of affective disorders, 234, 193-200. https://doi.org/10.1016/j.jad.2018.02.079

Merry, S., Hetrick, S., Cox, G., Brudevold‐Iversen, T., Bir, J., & McDowell, H. (2012). Cochrane Review: Psychological and educational interventions for preventing depression in children and adolescents. Evidence‐Based Child Health: A Cochrane Review Journal, 7(5), 1409-1685. https://doi.org/10.1002/ebch.1867

Merry, S., McDowell, H., Hetrick, S., Bir, J., & Muller, N. (2004). Psychological and/or educational interventions for the prevention of depression in children and adolescents. The Cochrane Database of Systematic Reviews, 7(12), 1-6. https://doi.org/10.1002/14651858.cd003380

Meyer, B., Berger, T., Caspar, F., Beevers, C., Andersson, G., & Weiss, M. (2009). Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial. Journal of medical Internet research, 11(2), 1-18. https://doi.org/10.2196/jmir.1151

Ministerio de la Protección Social de Colombia, Oficina de las Naciones Unidas contra la Droga y el Delito y Universidad CES. (2010). Situación de salud mental del adolescente. Estudio Nacional de Salud Mental Colombia. http://psicopediahoy.s3.amazonaws.com/saludmentaladolescentecolombia.pdf

Ministerio de Salud de Colombia. (2017). Boletín de Salud Mental Depresión. www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/ENT/boletin-depresion-marzo-2017.pdf

Muñoz, R., Beardslee, W., & Leykin, Y. (2012). Major depression can be prevented. American Psychologist, 67(4), 285-295. https://doi.org/10.1037/a0027666

O'Kearney, R., Gibson, M., Christensen, H., & Griffiths, K. (2006). Effects of a cognitive-behavioural internet program on depression, vulnerability to depression and stigma in adolescent males: a school-based controlled trial. Cognitive behaviour therapy, 35(1), 43-54. https://doi.org/10.1080/16506070500303456

O’Kearney, R., Kang, K., Christensen, H., & Griffiths, K. (2009). A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls. Depression and Anxiety, 26(1), 65-72. https://doi.org/10.1002/da.20507

Parada, F., Martínez, V., Espinosa, H., Bauer, S., & Moessner, M. (2019). Using persuasive systems design model to evaluate “Cuida tu Ánimo”: an internet-based pilot program for prevention and early intervention of adolescent depression. Telemedicine and e-Health, 26(2), 251-254. https://doi.org/10.1089/tmj.2018.0272

Pérez, C., Coo, S., Aldoney, D., & García, M. (2021). Considerations in the Development and Use of e-and-m- Mental Health in Latin American Contexts: Case Analysis of an m-Health Intervention to Prevent Postnatal Depression and Anxiety in Chilean Mothers. ISSBD Bulletin, 45(6), 14-21. https://issbd.org/resources/files/Bulletins/JBD_45_6S_Combined.pdf

Perry, Y., Werner, A., Calear, A., Mackinnon, A., King, C., Scott, J., … Batterham, P. (2017). Preventing depression in final year secondary students: school-based randomized controlled trial. Journal of Medical Internet Research, 19(11), 1-11. https://doi.org/10.26686/wgtn.12331265.v2

Quintero, C., Lugo, L., García, H., & Sánchez, A. (2011). Validación del cuestionario Kidscreen27 de calidad de vida relacionada con la salud en niños y adolescentes de Medellín, Colombia. Revista Colombiana de Psiquiatría, 40(3), 470-487. https://doi.org/10.1016/s0034-7450(14)60141-4

Richardson, L., McCauley, E., Grossman, D., McCarty, C., Richards, J., Russo, J., … Katon, W. (2010). Evaluation of the Patient Health Questionnaire 9 Item for Detecting Major Depression Among Adolescents. Pediatrics. 126(6), 1117-1123. https://doi.org/10.1542/peds.2010-0852

Rudolph, K. (2009). Adolescent depression. In I. Gotlib & C. Hammen (Ed.), Handbook of depression (pp. 444–466). The Guilford Press.

Rudolph, K., & Flynn, M. (2014). Depression in adolescents. I. Gotlib y C. Hammen (Ed.), Handbook of depression (pp. 614–444). The Guilford Press.

Spek, V., Cuijpers, P., Nyklicek, I., Riper, H., Keyzer, J., & Pop, V. (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine, 37(3), 319-328. https://doi.org/10.1017/S0033291706008944

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

Srivastava, K., Chaudhury, S., Dhamija, S., Prakash, J., & Chatterjee, K. (2020). Digital technological interventions in mental health care. Industrial Psychiatry Journal, 29(2), 181-184. https://doi.org/10.4103/ipj.ipj_32_21

Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L., … Goldsmith, C. (2010). A tutorial on pilot studies: the what, why and how. BMC Medical Research Methodology, 10(1), 1-10. https://doi.org/10.1186/1471-2288-10-1

Torres de Galvis, Y., Castaño Pérez, G., Sierra Hincapié, G., Salas Zapata, C., & Bareño Silva, J. (2020). Estudios de Salud Mental Medellín 2019. Universidad CES y Alcaldía de Medellín. https://repository.ces.edu.co/handle/10946/5131

Twomey, C., O'Reilly, G., Byrne, M., Bury, M., White, A., Kissane, S., … Clancy, N. (2014). A randomized controlled trial of the computerized CBT programme, MoodGYM, for public mental health service users waiting for interventions. British Journal of Clinical Psychology, 53(4), 433-450. https://doi.org/10.1111/bjc.12055

Van Voorhees, B., Fogel, J., Pomper, B., Marko, M., Reid, N., Watson, N., … Domanico, R. (2009). Adolescent dose and ratings of an Internet-based depression prevention program: A randomized trial of primary care physician brief advice versus a motivational interview. Journal of Cognitive and Behavioral Psychotherapies, 9(1), 1-19. https://doi.org/10.1016/j.trsl.2011.07.006

World Health Organization (WHO). (2021). Depression. http://www.who.int/mediacentre/factsheets/fs369/en/

Wolitzky-Taylor, K., Dour, H., Zinbarg, R., Mineka, S., VrshekSchallhorn, S., Epstein, A., … Craske, M. (2014). Experiencing core symptoms of anxiety and unipolar mood disorders in late adolescence predicts disorder onset in early adulthood. Depress Anxiety. 2014, 31(3), 207-213. https://doi.org/10.1002/da.22250

Published

2022-09-16

How to Cite

Espinosa-Duque, D., Fernandez, M., Ruiz, M. P., Jaramillo, J. C., Moessner, M., Bauer, S., & Krause, M. (2022). Feasibility and effectiveness of an Internet-based program for the prevention and early intervention of depression inInternet adolescents. CES Psicología, 15(3), 42–62. https://doi.org/10.21615/cesp.5428

Issue

Section

Artículos Originales
QR Code
Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
Crossref Cited-by logo

Some similar items: