A cluster randomized controlled trial to assess the effectiveness of an intervention to educate students about depression

Background. Depression is an important cause of disability worldwide, with many people experiencing their first depressive episode before the age of 18. University students are particularly vulnerable to depression. Depression can be treated successfully in most patients. However, for treatment to be successful, depressed people need to recognize their symptoms as illness, present to medical care, and be aware that effective treatment is available. A thoughtful health campaign might therefore increase the likelihood of successful treatment. Method. A cluster randomized controlled trial was conducted to determine the effectiveness of an educational intervention. A total of 3313 undergraduate students participated in the study. The intervention consisted of postcards and posters on depression and its treatment. The primary outcome was student awareness that depression can be treated effectively. Secondary outcomes included the proportion of students reading the postcards, recognition of symptoms and knowledge of treatments. Results. The postcards were read by 69 % of students. Less than half of participants reported that depression could be treated effectively, and there was no evidence of a difference between the intervention and control groups [341 (49.1 %) v. 379 (49.7 %), difference -0.7, p=0.8, 95 % confidence interval (0) - 5.1 to 3.7]. However, intervention group participants were more likely than control group participants to recognize depressive symptoms and to report that antidepressants are not addictive. Conclusions. Many university students lack knowledge about depression and its treatment. Simple and cheap media, such as postcards and posters, might help to improve awareness in areas where current knowledge is low.