Major Depression in Postconflict Northern Uganda: A Case Report

Abstract
“Ms. A” was a 49-year-old mother of five with a long-standing history of depressive symptoms and a 3-year history of HIV infection. She was receiving antiretroviral therapy at Mucwini Health Center III in Kitgum District at the time of her mental health evaluation by staff at the Peter C. Alderman Foundation (PCAF) clinic. She had a score of 18 on the 20-item Self-Reporting Questionnaire (SRQ-20), a depression and anxiety screening measure on which a score ≥6 indicates significant depression and anxiety symptoms; a mean total score of 2.1 on the culturally adapted Harvard Trauma Questionnaire, a posttraumatic stress symptom measure on which a score of 2.25 indicates significant posttraumatic stress symptoms; and a score of 7 on a locally developed functional assessment tool, indicating moderate impairment. She was clinically diagnosed with moderate to severe major depression with posttraumatic stress symptoms and was started on 50 mg/day of amitriptyline. Given the multiple persistent stressors in her life, she was deemed a good candidate for a weekly eight-session group support psychotherapeutic intervention that had been locally developed to treat depression in HIV-affected individuals. After completing the intervention, Ms. A’s depressive symptoms were reduced by 60%, her functioning scores had increased by 30%, her social support and self-esteem were enhanced, and she was able to engage in income-generating activities. The PCAF clinic staff decided to maintain her on antidepressant medication for 1 year.
Description
Keywords
Postconflict, Depression, Antiretroviral therapy
Citation
Nakimuli-Mpungu, E., Odokonyero, R., Laker, J., & Alderman, S. (2014). Major depression in postconflict Northern Uganda: A case report. American Journal of Psychiatry, 171(9), 925-928.https://doi.org/10.1176/appi.ajp.2014.14020261