title: Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV-affected Ugandan adults: a pilot study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NY, USA. Electronic address: ethelmpungu@yahoo.com.
authors.forename: Etheldreda
authors.initials: E
authors.lastname: Nakimuli-Mpungu
authors.affiliation: African Center for Tortured Victims, Kampala, Uganda.
authors.forename: Kizito
authors.initials: K
authors.lastname: Wamala
authors.affiliation: Peter C. Alderman Foundation, NY, USA; Gulu University, Department of Psychiatry, Gulu, Uganda.
authors.forename: James
authors.initials: J
authors.lastname: Okello
authors.affiliation: Peter C. Alderman Foundation, NY, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Alderman
authors.affiliation: Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NY, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Odokonyero
authors.affiliation: Makerere University, College of Health Sciences, Kampala, Uganda; Peter C. Alderman Foundation, NY, USA.
authors.forename: Seggane
authors.initials: S
authors.lastname: Musisi
authors.affiliation: Johns Hopkins School of Public Health, Department of Mental Health, Baltimore, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Faculty of Health Sciences, University of Ottawa, Canada.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mills
mesh_terms: D000328:Adult; D003466:Cultural Characteristics; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011615:Psychotherapy, Group; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology
keywords: Depression; Function; Group support psychotherapy; HIV/AIDS; Northern Uganda; Social support