Volume 17 Num. 2 - June 2017
Effect of Cognitive Behaviour Therapy on Depressive Symptoms among HIV-Infected Outpatients in Kenya
Volume 17 Num. 2 - June 2017 - Pages 161-173
Authors:
Japheth O Adina , Ezra K Maritim , Aggrey M Sindabi , Margaret A Disiye
Abstract:
Timely diagnosis and treatment of depression among persons living with HIV (PLWH) in sub-Saharan Africa which is home to about 70% of global HIV infection is disproportionately low. In Kenya, the effect of cognitive behaviour therapy (CBT) for depression has scarcely been established through a study. Hence, we conducted an experimental study to test the effectiveness of CBT for depression among PLWH attending outpatient clinics in western Kenya. The intervention was a 2-hour weekly group-CBT conducted for 6 successive weeks. Out of 53 participants recruited, 26 were randomly assigned to CBT and 27 to control arms of the study. Data were collected using Patient Health Questionnaire (PHQ-9). Depression symptom was diagnosed for a score of >5 and reported functional impairment in the past 2 weeks. At baseline, the difference in median PHQ scores for CBT and control groups was not statistically significant (p= .644, 95%CI). At month-2, a significantly higher proportion of participants in the CBT condition had a reduction in depressive symptoms (a drop of 5.8 points) compared to those in the control arm who had a drop of 1.9 points (p= .001, 95% CI). We assessed the effect of CBT on depression and found a statistically significant result, Z= -3.276, p <.001, with a relatively large effect size (r= .5). The treatment effect of CBT was evidently sustained at 2 months post-treatment. We therefore recommend a larger randomised controlled trial to evaluate the effectiveness of CBT for long term treatment gains in similar settings.
Key words:
cognitive behavior therapy, depressive symptoms, HIV, Kenya, primary health care
Full Article
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