Neuropsychiatric Disease and Treatment (Oct 2018)

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

  • Takagaki K,
  • Okamoto Y,
  • Jinnin R,
  • Mori A,
  • Nishiyama Y,
  • Yamamura T,
  • Yokoyama S,
  • Shiota S,
  • Okamoto Y,
  • Miyake Y,
  • Ogata A,
  • Kunisato Y,
  • Shimoda H,
  • Kawakami N,
  • Furukawa TA,
  • Yamawaki S

Journal volume & issue
Vol. Volume 14
pp. 2633 – 2641


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Koki Takagaki,1 Yasumasa Okamoto,2 Ran Jinnin,2 Asako Mori,2 Yoshiko Nishiyama,3 Takanao Yamamura,4 Satoshi Yokoyama,2 Syouichi Shiota,5,6 Yuri Okamoto,1 Yoshie Miyake,1 Akiko Ogata,7 Yoshihiko Kunisato,8 Haruki Shimoda,9 Norito Kawakami,10 Toshi A Furukawa,11 Shigeto Yamawaki2 1Health Service Center, Hiroshima, Japan; 2Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan; 3Haruma City Office, Haruma, Japan; 4Kanazawa University Hospital Neuropsychiatry, Kanazawa, Japan; 5Japan Society for the Promotion of Science, Tokyo, Japan; 6Department of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan; 7Department of Psychology, Hiroshima University, Hiroshima, Japan; 8Department of Psychology, School of Human Sciences, Senshu University, Kawasaki, Japan; 9Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan; 10Department of Psychiatry of Mental Health, The University of Tokyo, Tokyo, Japan; 11Department of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public health, Kyoto, Japan 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