What question did this study set out to answer?

To determine if CATCH-IT training lowers depression risk in at-risk adolescents compared to general health education.

June 3, 2026Open Access

Effect of Internet-Based Cognitive Behavioral Humanistic and Interpersonal Training vs Internet-Based General Health Education on Adolescent Depression in Primary Care: A Randomized Clinical Trial

Puntos clave

To determine if CATCH-IT training lowers depression risk in at-risk adolescents compared to general health education.
Multicenter, randomized clinical trial involving 369 adolescents aged 13-18 years with subsyndromal depression.
Intervention group received CATCH-IT, a 20-module online psychoeducation course supported by motivational interviews.
Participants were assessed for depressive symptoms at multiple time points postrandomization.
CATCH-IT showed a hazard ratio of 0.82 for time to depressive episode relative to lower baseline CES-D10 scores; P=0.04.
Among participants with a CES-D10 score of 15, the hazard ratio was significantly lower at 0.20 (95% CI, 0.05-0.77).
Both groups experienced declines in depressive symptoms and increases in functional scores.

Resumen

Importance: Although 13% to 20% of American adolescents experience a depressive episode annually, no scalable primary care model for adolescent depression prevention is currently available. Objective: To study whether competent adulthood transition with cognitive behavioral humanistic and interpersonal training (CATCH-IT) lowers the hazard for depression in at-risk adolescents identified in primary care, as compared with a general health education (HE) attention control. Design, Setting, and Participants: This multicenter, randomized clinical trial, a phase 3 single-blind study, compares CATCH-IT with HE. Participants were enrolled from 2012 to 2016 and assessed at 2, 6, 12, 18, and 24 months postrandomization in a primary care setting. Eligible adolescents were aged 13 to 18 years with subsyndromal depression and/or history of depression and no current depression diagnosis or treatment. Of 2250 adolescents screened for eligibility, 446 participants completed the baseline interview, and 369 were randomized into CATCH-IT (n = 193) and HE (n = 176). Interventions: The internet-based intervention, CATCH-IT, is a 20-module (15 adolescent modules and 5 parent modules) online psychoeducation course that includes a parent program, supported by 3 motivational interviews. Main Outcomes and Measures: Time to event for depressive episode; depressive symptoms at 6 months. Results: Of 369 participants (mean SD age, 15.4 1.5 years; 251 women 68%) included in this trial, 193 were randomized into CATCH-IT and 176 into HE. Among these participants, 28% had both a past episode and subsyndromal depression; 12% had a past episode only, 59% had subsyndromal depression only, and 1% had borderline subsyndromal depression. The outcome of time to event favored CATCH-IT but was not significant with intention-to-treat analyses (unadjusted hazard ratio HR, 0.59; 95% CI, 0.27-1.29; P =.18; adjusted HR, 0.53; 95% CI, 0.23-1.23; P =.14). Adolescents with higher baseline Center for Epidemiologic Studies Depression scale (CES-D10) scores showed a significantly stronger effect of CATCH-IT on time to event relative to those with lower baseline scores (HR 0.82; 95% CI, 0.67-0.99; P =.04). For example, the hazard ratio for a CES-D10score of 15 was 0.20 (95% CI, 0.05-0.77), compared with a hazard ratio of 1.44 (95% CI, 0.41-5.03) for a CES-D10score of 5. In both CATCH-IT and HE groups, depression symptoms declined and functional scores increased. Conclusions and Relevance: For preventing depressive episodes CATCH-IT may be better than HE for at-risk adolescents with subsyndromal depression. Also CATCH-IT may be a scalable approach to prevent depressive episodes in adolescents in primary care. Trial Registration: ClinicalTrials.gov Identifier: NCT01893749

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