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Depression is the leading cause of disability worldwide, and it is particularly problematic among adolescents given the risk for greater depression chronicity across the lifespan. Untreated depression exerts a huge economic toll as it impairs cognitive functioning, interpersonal relationships, interferes with schooling and disrupts work and productivity.

These impairments have a greater impact on adolescents in low- and middle-income countries due to the additional adversities they face and the lack of available, effective treatments.

 This three year project will use smartphones to deliver a digital intervention for adolescents, supported by local lay counsellors, to reduce depression and facilitate successful transitions to adulthood. We will adapt a tailored psychological therapy, Behavioural Activation (BA), among adolescents (15 to 19 years old) living in rural South Africa and Uganda. We will test the effectiveness of delivery of BA for reducing depression (primary outcome), and possible mechanisms, principally executive function and social cognition. As secondary outcomes, we will assess risk-taking behaviours and a range of human capital outcomes. Further, the proposed work will produce relevant measures of executive functions and social cognition through language translation and cultural adaptation and evaluate their reliability and validity in a rural context.

The team comprises a multidisciplinary group of psychologists, psychiatrists, neuroscientists and economists from South Africa (University of the Witwatersrand), Uganda (BRAC),  as well as from the UK (University of Oxford, University of Exeter, University College London) and the USA (University of California, Los Angeles, UCLA).