Enduring effects of a 5-week behavioral activation program for subthreshold depression among late adolescents: an exploratory randomized controlled trial

Abstract

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

Acknowledgments

This study was supported by Grants-in-Aid for Scientific Research on Innovative Areas, Grant Numbers 16H06395 and 16H06399 from Japan Society for the Promotion of Science, and Grant Number 23118004 from the Ministry of Education, Culture, Sports, Science and Technology, Japan. No funding entity influenced the results or presentation of the study results. The authors would like to thank all participants.

Author contributions

All authors contributed to the design, acquisition of data, interpretation of data drafting, and critical revision of the paper, and agree to be accountable for all aspects of the work. All authors have approved the final article.

Disclosure

The authors have no conflict of interest, financial or otherwise, related to this study.