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Preventing depression in Chinese children and adolescents: A pilot study of a brief school-based cognitive behavioral group program

J Affect Disord. 2026 Feb 1;394(Pt A):120559. doi: 10.1016/j.jad.2025.120559. Epub 2025 Oct 24.

ABSTRACT

PURPOSE: Depressive symptoms are common among children and adolescents in China, yet few rigorously evaluated, evidence-based prevention programs have been developed. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of Power Up: Cognitive Behavioral Therapy for Depressive Symptoms (Power Up-CBTD), a brief, manualized group intervention tailored for Chinese school-aged youth with depressive symptoms.

METHODS: Eighty-seven students from grades 5, 6, and 9 who screened positive for depressive symptoms were randomly allocated to Power Up-CBTD or treatment-as-usual (TAU). Feasibility was assessed via attrition, attendance, satisfaction, and qualitative feedback. Symptoms of depression and anxiety were evaluated at baseline and post-intervention using the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), the Children’s Depression Inventory-Short Form (CDI-S), and the Screen for Child Anxiety Related Emotional Disorders (SCARED).

RESULTS: Among forty-three participants in the Power Up-CBTD group, one withdrew (attrition rate = 2.3 %), and mean attendance was 87.7 %. Satisfaction was reasonable (M = 28.4/32, SD = 4.06). Qualitative feedback reflected improved coping, positive group experiences, and interest in additional sessions. At post-intervention, depressive symptoms decreased significantly more in the Power Up-CBTD group than in TAU (CESD-R adjusted mean difference [AMD] = -10.89, p < .001; CDI-S AMD = -3.23, p < .001). While anxiety symptoms also declined, the between-group difference did not reach statistical significance (AMD = -6.68, p = .07).

CONCLUSION: Power Up-CBTD demonstrated reasonable feasibility and acceptability, showing promising preliminary effects in reducing depressive symptoms among school-aged youth in mainland China. Larger randomized trials with extended follow-up are warranted.

PMID:41284544 | DOI:10.1016/j.jad.2025.120559