TY - JOUR
T1 - Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV affected Ugandan adults
T2 - A pilot study
AU - Nakimuli-Mpungu, Etheldreda
AU - Wamala, Kizito
AU - Okello, James
AU - Alderman, Stephen
AU - Odokonyero, Raymond
AU - Musisi, Seggane
AU - Mojtabai, Ramin
AU - Mills, Edward J.
N1 - Funding Information:
The study was funded by the Grand Challenges Canada: Rising Stars in Global Health Award , Grant no. 0124-01 .The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
E.N.-M. was supported by the Grand Challenges Canada: Rising Stars in Global Health Award, Grant Number 0124-01.
Funding Information:
The authors would like to acknowledge the support of the management of the Gulu and Kitgum local government administration and regional referral hospitals where the two PCAF trauma clinics are situated, as well as the mental health section of the Ministry of Health, Uganda. We appreciate the support from the Peter C. Alderman Foundation. We are extremely grateful for the hard work of all research assistants especially Jean Laker, Milton Ojede and Elizabeth Nakanjako who collected data for this project. Lastly, we thank the study participants for their time and trust.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/9
Y1 - 2014/9
N2 - Background 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. Methods 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. Results 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. Limitations 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. Conclusions 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.
AB - Background 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. Methods 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. Results 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. Limitations 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. Conclusions 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.
KW - Depression
KW - Function
KW - Group support psychotherapy
KW - HIV/AIDS
KW - Northern Uganda
KW - Social support
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U2 - 10.1016/j.jad.2014.05.005
DO - 10.1016/j.jad.2014.05.005
M3 - Article
C2 - 25012423
AN - SCOPUS:84901746347
SN - 0165-0327
VL - 166
SP - 144
EP - 150
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -