Implementation and effectiveness of a sustained depression prevention program for high school students in Japan

ABSTRACT

In Japan, many high school students have severe depression. Preventive interventions for school-based cognitive-behavioral depression are effective countermeasures against depressive problems among high school students. However, since high school curriculums are time-consuming, such interventions are less common among high school students. Therefore, we conducted a long-term but low-frequency intervention that divides the program content through several grades. We examined the effectiveness of our intervention based on the data obtained by a survey during the two-year intervention period and one-year follow-up period for 225 students who had enrolled in 2014–2019. Three-level hierarchical linear model analysis showed that students who participated in the program had improved depressive symptoms and related factors over these three years. The Welch test and chi-square test showed fewer depressive symptoms and a lower percentage of students with depression than the 608 Japanese students who did not receive the intervention; data were collected through an online survey at the end of the program and one year after the intervention ended. The results suggest that a school-based cognitive-behavioral depression prevention program using a long-term but low-frequency approach may effectively reduce the implementation burden into the school curriculum, promote sustained implementation, and prevent depression among high school students.

要約

日本では，多くの高校生が深刻な抑うつ状態にある。高校生の抑うつ問題解消のためには，学校規模の認知行動的抑うつ予防介入が有効であるが，高校のカリキュラムは教科教育のために多くの時間を割いているため，高校生に対する学校規模の抑うつ予防介入はあまり実施されていないのが現状である。そこで私たちは，プログラム内容を複数の学年に分けることで，長期的だが低頻度の抑うつ予防プログラムを複数年にわたって実践し，その効果検証を行った。介入実施校に2014年から2019年に入学した225名の生徒を対象に，2年間の介入期間と1年間のフォローアップ期間で得られた調査データを用いて，3レベルの階層線形モデル分析を行った。その結果，プログラムを受けた生徒は3年間で，抑うつとその関連要因が改善したことが示された。また，オンライン調査により，介入終了時点とその1年後時点における本プログラムを受けていない日本人生徒608名のデータを取得し，Welch検定とカイ二乗検定を用いて比較分析を行った結果，本プログラムを受けた生徒は受けていない生徒よりも抑うつが低く，抑うつ状態にある生徒の割合も少ないことが示された。これらの結果から，長期的だが低頻度の学校規模の認知行動的抑うつ予防プログラムが，学校カリキュラムへの導入負担を軽減し，持続的な実施を促進するとともに，高校生の抑うつを予防する効果を有することが示唆された。

KEYWORDS:

• Depression
• prevention
• high school
• school-based program
• universal intervention

View correction statement:

Correction

Acknowledgments

We thank the teachers for their cooperation and the students who participated in this study. We gratefully acknowledge the work of past and present members of Akiko Ogata’s Laboratory.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, Yugo Kira, upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21683603.2023.2243858

Additional information

Funding

This work was supported by JSPS KAKENHI under Grant Number [19J12631] and [21K13702], and by MEXT KAKENHI under Grant Number 18K03138.

Notes on contributors

Yugo Kira

Yugo Kira is an lecturer at the Department of Social and Clinical Psychology, Hijiyama University, Japan. He received his Ph.D. degree in Psychology from Hiroshima University.

Misuzu Matsumoto

Misuzu Matsumoto is a Ph.D. student at the Graduate School of Humanities and Social Sciences, Hiroshima University, Japan. She received her Master’s degree in Psychology from Hiroshima University.

Kohei Kambara

Kohei Kambara is an assistant professor at the Faculty of Psychology, Doshisha University, Japan. He received his Ph.D. degree in Psychology from Hiroshima University.

Akiko Ogata

Akiko Ogata is an associate professor at the Graduate School of Humanities and Social Sciences, Hiroshima University, Japan. She received her Ph.D. degree in Psychology from Hiroshima University.