Group interpersonal psychotherapy for depression in rural Uganda: 6-Month outcomes: Randomised controlled trial

Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, 5th Floor, Boston, MA 02118, USA.
The British Journal of Psychiatry (Impact Factor: 7.99). 06/2006; 188:567-73. DOI: 10.1192/bjp.188.6.567
Source: PubMed


A randomised controlled trial comparing group interpersonal psychotherapy with treatment as usual among rural Ugandans meeting symptom and functional impairment criteria for DSM-IV major depressive disorder or sub-threshold disorder showed evidence of effectiveness immediately following the intervention.
To assess the long-term effectiveness of this therapy over a subsequent 6-month period.
A follow-up study of trial participants was conducted in which the primary outcomes were depression diagnosis, depressive symptoms and functional impairment.
At 6 months, participants receiving the group interpersonal psychotherapy had mean depression symptom and functional impairment scores respectively 14.0 points (95% CI 12.2-15.8; P<0.0001) and 5.0 points (95% CI 3.6-6.4; P<0.0001) lower than the control group. Similarly, the rate of major depression among those in the treatment arm (11.7%) was significantly lower than that in the control arm (54.9%) (P<0.0001).
Participation in a 16-week group interpersonal psychotherapy intervention continued to confer a substantial mental health benefit 6 months after conclusion of the formal intervention.

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    • "), cognitive-behaviour therapy (Rahman et al. 2008; Ali et al. 2010), group-based psychoeducation (Araya et al. 2003; Bolton et al. 2003; Lara et al. 2003; Bass et al. 2006), home visits (Baker-Henningham et al. 2005 "
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    ABSTRACT: Background Maternal depression is associated with poor child development and growth in low-income countries. This paper evaluates the effect of a community-based trial providing psychosocial stimulation and food supplements to severely malnourished children on maternal depressive symptoms in Bangladesh.Methods Severely underweight (weight-for-age Z-score < −3) hospitalized children aged 6–24 months (n = 507), were randomly assigned to: psychosocial stimulation (PS), food supplementation (FS), PS+FS, clinic control (CC) and hospital control (CH) at discharge. PS included play sessions with children and parental counselling to mothers during fortnightly follow-up visit at community clinics, conducted by trained play leaders for 6 months. FS involved cereal-based supplements (150–300 kcal/day) for 3 months. All groups received medical care, micronutrient supplements and growth monitoring. We used Bayley scales, Home Observation for Measurement of Environment (HOME) inventory and a parenting questionnaire to assess child development, home stimulation and mothers' child-rearing practices, respectively. We assessed mothers' depressive symptoms using a modified version of Centre for Epidemiologic Studies Depression Scale at baseline and at 6 months post intervention.ResultsMaternal depressive symptoms were significantly lower in the CH group at baseline (P = 0.014). After 6 months of intervention there was no significant effect of intervention after adjusting for baseline scores and all possible confounders. Maternal depressive symptoms were higher among poorer (P = 0.06), older (P = 0.057) and less educated (P = 0.019) mothers, who were housewives (P = 0.053), and whose husbands had more unstable jobs (P = 0.058). At 6 months post intervention, children's cognitive (P = 0.045) and motor (P = 0.075) development, HOME (P = 0.012) and mother's parenting score (P = 0.057) were higher among mothers with lower depressive symptoms.Conclusion The study did not show a significant effect of the intervention on the level of maternal depressive symptoms. Interventions with higher intensity and/or of longer duration focusing directly on maternal psychosocial functioning are probably needed to reduce maternal depressive symptoms.
    Child Care Health and Development 08/2014; 41(3). DOI:10.1111/cch.12176 · 1.69 Impact Factor
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    • "Group interventions have become increasingly popular for supporting persons affected by chronic illness (Sherman et al., 2004a, 2004b). In Uganda, clinical trials of adapted western psychotherapeutic interventions have focused on the impact of group interpersonal therapy on post-traumatic stress symptoms in highly selective samples of children in post-conflict settings (Bolton et al., 2007; Verdeli et al., 2008) and adults in nonconflict settings respectively (Bolton et al., 2003; Bass et al., 2006). While there is growing evidence that group psychosocial interventions are helpful, the effectiveness of these interventions for adults with depression and post-traumatic stress symptoms in post-conflict setting is less clear especially in sub-Saharan Africa. "
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    Journal of Affective Disorders 06/2013; 151(1). DOI:10.1016/j.jad.2013.05.055 · 3.38 Impact Factor
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    • "mean difference Std . mean difference IV , Random , 95% CI IV , Random , 95% CI 1 . 1 . 1 Interpersonal therapy Bolton et al ( 2003 ) 17 / Bass et al ( 2006 ) 18 de Mello et al ( 2001 ) 19 Ye & Ming ( 2006 ) 20 Subtotal ( 95% CI ) Heterogeneity : t 2 = 0 . 10 ; w 2 = 6 . "
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    The British journal of psychiatry: the journal of mental science 04/2013; 202(4):253-60. DOI:10.1192/bjp.bp.112.118018 · 7.99 Impact Factor
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