JMIR Publications

ABSTRACT

Background:

Depression is common during adolescence. Early intervention could prevent it from developing into more progressive mental disorders. Combining information technology and clinical psychoeducation is a promising way to intervene at an earlier stage. However, we lack data-driven research about the cognitive response to health information targeting adolescents with symptoms of depression.

Objective:

Our primary objective was to fill this knowledge gap through a new understanding of adolescents’ cognitive response to health information about depression. We may apply such knowledge to develop population-specific information technology such as chatbots, alongside clinical therapeutic tools for use in general practice.

Methods:

The dataset consists of 1870 depression related questions posted by adolescents on a public online information website. Most of the posts contain descriptions of events leading to depression. On a sample of 100 posts, we conducted a qualitative thematic analysis based on cognitive behavioral theory investigating behavioral, emotional, and symptom response to beliefs associated with depression.

Results:

Skills associated with self-management, such as seeking social support with an attitude of self-action, seem to generate positive symptom responses. Setting unrealistic goals for self-management could generate negative responses. We observe hopelessness as a set of negative secondary beliefs about the future exaggerated by a depressed mood, influenced by primary beliefs about etiology and natural course, therapy initiation and prognosis. Negative beliefs about therapy prognosis reduce hope and increase therapy hesitancy. Experiencing symptoms and the ensuing loss of function seems to evoke shame. Suicidal ideation seems to be reduced by imagining the pain a suicide will inflict on the parents.

Conclusions:

Health information and psychoeducation is suggested to: Balance the message of self-management according to individual skills. Advise the patient to approach the social environment demonstrating self-action. Challenge negative beliefs about the future directly. Target information about etiology, natural course, and therapy to instill hope, thereby stimulating therapy motivation, and reduce therapy hesitancy. Give a tentative diagnosis despite the risk of stigmatizing. This could help parents and caregivers to facilitate a caring and understanding social environment, thus reducing suicidal ideation.