Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV-affected Ugandan adults: a pilot study.

Journal: Journal of affective disorders

Volume: 166

Issue: 

Year of Publication: 2014

Affiliated Institutions:  Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NY, USA. Electronic address: ethelmpungu@yahoo.com. African Center for Tortured Victims, Kampala, Uganda. Peter C. Alderman Foundation, NY, USA; Gulu University, Department of Psychiatry, Gulu, Uganda. Peter C. Alderman Foundation, NY, USA. Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NY, USA. Johns Hopkins School of Public Health, Department of Mental Health, Baltimore, USA. Faculty of Health Sciences, University of Ottawa, Canada.

Abstract summary 

Psychotherapy is the recommended first line treatment for mild to moderate depression. However, its availability in low resource settings is limited. We developed a manualized culturally sensitive group support psychotherapeutic intervention for depressed HIV affected Ugandan adults. In this study, we aimed to assess its feasibility, acceptability and impact on depression, functioning, social support and self-esteem.A total of 77 depressed individuals were assigned to the group intervention (n=48) and a wait-list control group (n=29), and assessed before, during and at the end of the intervention. The self-reporting questionnaire, a locally relevant function assessment instrument, the Rosenberg self-esteem scale, and the multiple dimensions perceived social support scale were administered to assess depression symptoms, functioning, self-esteem and social support at three assessment periods. Multivariate longitudinal regression models were used to determine change in outcomes over time between the two groups. Participants were asked to evaluate the intervention.Post -intervention assessments indicate that, in comparison to the wait-list control group, the intervention group had a faster reduction in depression symptom scores [OR=0.00,95% CI, 0.00-0.003] and faster increase in functioning scores [OR=4.82, 95% CI, 2.39 to 9.75], social support scores [OR=2.68, 95% CI, 1.50-4.78] and self-esteem [OR=1.90, 95% CI 1.48-2.44]. Sixty-three percent of participants strongly agreed that the intervention had reduced their depression and would recommend it to other depressed individuals.Inadequate study power due to small sample sizes may result in imprecise confidence intervals even when there are significant differences. The use of non-random samples could have resulted in selection bias.This intervention appears feasible, acceptable and promising in treating depression and restoring function, enhancing social support and self-esteem. Larger and randomized evaluations are warranted.

Authors & Co-authors:  Nakimuli-Mpungu Etheldreda E Wamala Kizito K Okello James J Alderman Stephen S Odokonyero Raymond R Musisi Seggane S Mojtabai Ramin R Mills Edward J EJ

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : 10.1016/j.jad.2014.05.005
SSN : 1573-2517
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Depression;Function;Group support psychotherapy;HIV/AIDS;Northern Uganda;Social support
Study Design
Randomized Control Trial,Case Control Trial,Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
Netherlands