Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda: A Randomized Controlled Trial
Loading...
Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Jama
Abstract
Prior qualitative work with internally displaced persons in war-affected northern
Uganda showed significant mental health and psychosocial problems.
Objective To assess effect of locally feasible interventions on depression, anxiety,
and conduct problem symptoms among adolescent survivors of war and displacement
in northern Uganda.
Design, Setting, and Participants A randomized controlled trial from May 2005
through December 2005 of 314 adolescents (aged 14-17 years) in 2 camps for internally
displaced persons in northern Uganda.
Interventions Locally developed screening tools assessed the effectiveness of interventions
in reducing symptoms of depression and anxiety, ameliorating conduct
problems, and improving function among those who met study criteria and were randomly
allocated (105, psychotherapy-based intervention [group interpersonal psychotherapy];
105, activity-based intervention [creative play]; 104, wait-control group
[individuals wait listed to receive treatment at study end]). Intervention groups met
weekly for 16 weeks. Participants and controls were reassessed at end of study.
Main Outcome Measures Primary measure was a decrease in score (denoting improvement)
on a depression symptom scale. Secondary measures were improvements in
scores on anxiety, conduct problem symptoms, and function scales. Depression, anxiety,
and conduct problems were assessed using the Acholi Psychosocial Assessment Instrument
with a minimum score of 32 as the lower limit for clinically significant symptoms
(maximum scale score, 105).
Results Difference in change in adjusted mean score for depression symptoms between
group interpersonal psychotherapy and control groups was 9.79 points (95%
confidence interval [CI], 1.66-17.93). Girls receiving group interpersonal psychotherapy
showed substantial and significant improvement in depression symptoms compared
with controls (12.61 points; 95% CI, 2.09-23.14). Improvement among boys
was not statistically significant (5.72 points; 95% CI, −1.86 to 13.30). Creative play
showed no effect on depression severity (−2.51 points; 95% CI, −11.42 to 6.39). There
were no statistically different improvements in anxiety in either intervention group.
Neither intervention improved conduct problem or function scores.
Conclusions Both interventions were locally feasible. Group interpersonal psychotherapy
was effective for depression symptoms among adolescent girls affected by
war and displacement. Other interventions should be investigated to assist adolescent
boys in this population who have symptoms of depression.
Description
Keywords
Depression Symptoms, Adolescent Survivors, War, Displacement
Citation
Bolton, P., Bass, J., Betancourt, T., Speelman, L., Onyango, G., Clougherty, K. F., ... & Verdeli, H. (2007). Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. Jama, 298(5), 519-527.