***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A controlled trial was conducted to evaluate a prevention program aim ed at reducing depressive and anxious symptoms in rural school children . Seventh- grade children with elevated depression were selected . Nine primary schools ( n = 90 ) were r and omly assigned to receive the program , and 9 control schools ( n = 99 ) received their usual health education classes .  Children completed question naires on depression , anxiety , explanatory style , and social skills . Parents completed the Child Behavior Checklist ( T. M. Achenbach , 1991 ) . No intervention effects were found for depression . Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention . Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only OBJECTIVE To conduct a placebo-controlled study of the effectiveness of a universal school-based depression prevention program . METHOD Three hundred ninety-two students age 13 to 15 from two schools were r and omized to intervention ( RAP-Kiwi ) and placebo programs run by teachers . RAP-Kiwi was an 11-session manual-based program derived from cognitive-behavioral therapy . The placebo was similar but with cognitive components removed . Outcomes were self-rated depression scales , the Reynolds Adolescent Depression Scale ( RADS ) , and the Beck Depression Inventory II ( BDI-II ) . Follow-up was to 18 months . Analysis was done on an intent-to-treat basis . RESULTS Immediately after the intervention , depression scores were reduced significantly more by RAP-Kiwi than by placebo , with a mean difference in change from baseline between groups of 1.5 on BDI-II ( CI > 0.38 , p = .01 ) and 2.24 on RADS ( CI > 0.22 , p = .04 ) . Categorical analysis confirmed significant clinical benefit with an absolute risk reduction of 3 % ( 95 % CI , 1 - 11 % , McNemar chi , p = .03 ) , with the " number needed to treat " for short-term benefit of 33 . Group differences in depression scores averaged across time to 18 months were significant on RADS but not on BDI-II . Retention rates were 91 % at 6 months and 72 % at 18 months . CONCLUSIONS The RAP-Kiwi program is a potentially effective public health measure . Confirmation of effectiveness measuring episodes of depressive illness and broader measures of adjustment is warranted The authors investigated the effectiveness and specificity of the Penn Resiliency Program ( PRP ; J. E. Gillham , L. H. Jaycox , K. J. Reivich , M. E. P. Seligman , & T. Silver , 1990 ) , a cognitive-behavioral depression prevention program . Children ( N = 697 ) from 3 middle schools were r and omly assigned to PRP , Control ( CON ) , or the Penn Enhancement Program ( PEP ; K. J. Reivich , 1996 ; A. J. Shatté , 1997 ) , an alternate intervention that controls for nonspecific intervention ingredients . Children 's depressive symptoms were assessed through 3 years of follow-up . There was no intervention effect on average levels of depressive symptoms in the full sample . Findings varied by school . In 2 schools , PRP  significantly reduced depressive symptoms across the follow-up relative to both CON and PEP . In the 3rd school , PRP did not prevent depressive symptoms . The authors discuss the findings in relation to previous research on PRP and the dissemination of prevention programs This paper describes the development and preliminary efficacy of a program design ed to prevent depressive symptoms in at-risk 10 - 13 year-olds , and relates the findings to the current underst and ing of childhood depression . The treatment targets depressive symptoms and related difficulties such as conduct problems , low academic achievement , low social competence , and poor peer relations , by proactively teaching cognitive techniques .  Children were identified as ' at-risk ' based on depressive symptoms and their reports of parental conflict . Sixty-nine children participated in treatment groups  and were compared to 73 children in control groups .  Depressive symptoms were significantly reduced and classroom behavior was significantly improved in the treatment group as compared to controls at post-test . Six-month follow-up showed continued reduction in depressive symptoms , as well as significantly fewer externalizing conduct problems , as compared to controls . The reduction in symptoms was most pronounced in the children who were most at risk This study evaluated the Penn Resiliency Program 's effectiveness in preventing depression when delivered by therapists in a primary care setting . Two-hundred and seventy-one 11- and 12-year-olds , with elevated depressive symptoms , were r and omized to PRP or usual care . Over the 2-year follow-up , PRP improved explanatory style for positive events .  PRP 's effects on depressive symptoms and explanatory style for negative events were moderated by sex , with girls benefiting more than boys . Stronger effects were seen in high-fidelity groups than low-fidelity groups . PRP did not significantly prevent depressive disorders but significantly prevented depression , anxiety , and adjustment disorders ( when combined ) among high-symptom participants . Findings are discussed in relation to previous PRP studies and research on the dissemination of psychological interventions BACKGROUND  Depressive disorders in adolescents are a widespread and increasing problem . Prevention seems a promising and feasible approach . METHODS We design ed a cognitive-behavioral school-based universal primary prevention program and followed 347 eighth- grade students participating in a r and omized controlled trial for three months . RESULTS In line with our hypothesis , participants in the prevention program remained on a low level of depressive symptoms , having strong social networks . The control group showed increasing depressive symptoms and a reduced social network . Contrary to our expectations , students low in self-efficacy benefited more from the program than high self-efficient students . Social network did not mediate the relationship between participation in the prevention program and changes in depressive symptoms . CONCLUSIONS Our results show that the prevention program had favorable effects . Further research is needed to explore the impact of self-efficacy on the effects of prevention programs 
    Output:
    
Results and conclusion Limited evidence was found to indicate that CBT , regardless of its content ( i.e. with or without hopeful elements ) , is effective at preventing the onset of clinical levels of depression in young people on a sustained basis .