Benjamin Van Voorhees, MD, MPH
Associate Professor & Head, Department of Pediatrics
UIC College of Medicine
UI Health Children’s Hospital
Mental Disorders among Adolescents: Reducing Morbidity through Preventive Technology-Based Interventions in Primary Care & Community Settings
Introduction: Approximately one in five children and adolescents lives with a mental health condition. Onset of depression most frequently occurs during adolescence, and 13-20% of teens ages 13 to 18 years are living with the condition today. Furthermore, rates of depression are higher among African American and Latino adolescents than their white counterparts. Adolescents who experience mental disorders, including depression, are less likely to graduate from high school and participate in the work force. They are more likely to experience dysfunctional relationships in the future. Research has shown that combining medical and behavioral care, especially in the primary care setting, can lead to improvements in youth mental health outcomes. Furthermore, study outcomes support the effectiveness of technology/internet-based preventative interventions. In order to address adolescent depression and integrate new, evidence-based research findings, Dr. Van Voorhees began development of CATCH-IT, “Competent Adulthood Transition with Cognitive, Humanistic, and Interpersonal Training” in 2002, a technology-based behavioral vaccine to prevent adolescent depression. Since then, it has evolved into a comprehensive approach that includes intervention development, mechanisms of action, motivation, clinical epidemiology, and health economics.
Methodology/Findings/Results: From 2011-2018, Dr. Van Voorhees has led a multi-center clinical trial called the Promoting Adolescent Health (PATH) Study, involving nearly 2,000 teens, parents, and healthcare providers in two major cities, Chicago & Boston. Eligible teens must be between the ages of 13-18; have current symptoms of depression and/or a past episode of depression; no history of cognitive behavioral or interpersonal psychotherapy; no current significant drug or alcohol abuse; and no current significant suicidal ideation. The PATH study aims to determine if teaching coping skills on-line using CATCH-IT, in combination with primary care-based motivational interviewing, will be superior to health education in preventing adolescent depression. CATCH-IT uses design elements and interactive components to engage adolescents, building upon behavioral activation, cognitive behavioral and interpersonal psychotherapy approaches. Both CATCH-IT and Health Education engage teens in a series of online modules. CATCH-IT also employs a parent intervention. Ultimately, 369 teens were randomized into the trial and 193 were enrolled into the CATCH-IT group (176 in regular Health Education).
Conclusions: Preliminary results of the PATH Study indicate that adolescents in both the CATCH-IT and Health Education groups seem to experience fewer symptoms of depression and exhibit better overall functioning over time, which may be predicted by online module completion in both arms. Teens who, with their parents, complete a total of at least 2 CATCH-IT modules over the course of 6 months experience fewer episodes of subthreshold depression than those in Health Education. Additionally, across 6 months, CATCH-IT appears to be associated with fewer subthreshold depressive episodes than Health Education for teens with higher levels of depressive symptoms at baseline (study start). The PATH Study is still underway, with several participants still enrolled. Dr. Van Voorhees and colleagues will continue to measure outcomes and provide conclusive results at the end of the study. Furthermore, they intend to apply for additional funding to continue the research.
About Our Researcher: Benjamin Van Voorhees, MD, MPH, Associate Professor of Clinical Pediatrics, is Head of the Department of Pediatrics at the University of Illinois at Chicago (UIC) and Physician-in-Chief of Children’s Hospital University of Illinois (CHUI). He received his Doctor of Medicine from Vanderbilt University, and his Master of Public Health from Johns Hopkins University. He completed a Combined Internal Medicine-Pediatric Residency at Vanderbilt University Hospital and a General Internal Medicine Fellowship at Johns Hopkins. Between college and medical school, he served as an officer in the US Navy. His research on adolescent depression prevention and behavioral vaccines has been funded by the National Alliance for Research on Schizophrenia and Depression (NARSAD) and Robert Wood Johnson Foundation grants; a National Institute of Mental Health (NIMH) K-08, R-21, and RO-1 series; and the Centers for Medicare & Medicaid Services (CMS) Healthcare Innovation Award.
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