Clinical effectiveness of "Training for Awareness Resilience and Action" (TARA) compared to standard treatment for adolescents and young adults with depression- a randomized controlled trial

The purpose is to improve treatment of depressive disorders (DD) in youth.

The primary aim is to compare the clinical effectiveness of a new treatment paradigm Training for Awareness, Resilience and Action (TARA) and standard treatment (ST) in a randomized control trial with 1:1 allocation.

Secondary aims are to assess treatment effects on biomarkers of inflammation, cellular aging, neuroprotection, autonomic regulation and functional and structural connectivity.

The population is N=180 youth aged 15-22-years with DD recruited from child and youth psychiatric clinics in Northern Sweden.

TARA is a 12-week on-line, group intervention, targeting the chronic limbic hyperreactivity and delayed neurodevelopment seen in youth DD. The control is ST, including cognitive behavioral therapy and SSRIs according to National Guidelines. Primary outcome is the Reynolds Adolescent Depression Scale 2nd ed at 3 months from baseline (T1).

Secondary outcomes include clinical assessment with the Children´s Depression Rating Scale Revised at biomarker status at T1 and the same scales at 6 months follow up (T2). Recruitment starts 2021. Data collection will be finalized by 2024, and analyses and main manuscript by 2025.

Since early on-set DD is related to increased risk of recurrent episodes, and future psychiatric co-morbidity, somatic health conditions and increased overall mortality, more effective and sustainable treatment, will have major impact across the life-span and on public health.