Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda

A Randomized Controlled Trial

Bibliographic Data

ID23339709
AuthorsPaul Bolton (0000-0001-7162-7896, Boston University), Jeffrey Ba (0000-0002-5192-628X, Boston University), Judith Bass, Theresa Betancourt (0000-0002-3683-4440, Harvard University), Liesbeth Speelman, Grace Onyango (World Health Organization - Uganda), Kathleen F Clougherty (New York Psychoanalytic Society and Institute), Richard Neugebauer (Columbia University), Laura K Murray (0000-0003-0199-9701, Boston University), Laura Murray (0000-0001-8409-4697), Helen Verdeli (0000-0002-5963-8469, New York Psychoanalytic Society and Institute)
Year2007
Volume298
Issue5
Pages519
Publication date2007-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJAMA (JOURNAL)
Journal identifiersISSN: 0098-7484 • E-ISSN: 1538-3598
PublisherAmerican Medical Association (AMA) (PUBLISHER)
DOI10.1001/jama.298.5.519
PMID17666672
OpenAlexW2157421405
LanguageEN
Citations received129
References cited7

CONTEXT: 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. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00280319.

Anxiety · Depression (economics) · Interpersonal psychotherapy · Intervention (counseling) · Mental health · Physical therapy · Psychiatry · Psychological intervention · Psychosocial · Randomized controlled trial · Clinical Psychology · Health and Conflict Studies · Internal Medicine · Medicine · Migration, Health and Trauma · Posttraumatic Stress Disorder Research