Nusrat Husain1, Nasim Chaudhry2, Batool Fatima3, Meher Husain4, Rizwana Amin5, Imran Bashir Chaudhry6, Raza Ur Rahman7, Barbara Tomenson2, Farhat Jafri8, Farooq Naeem4, Francis Creed2. 1. University of Manchester, andLancashire Care NHS Foundation Trust,UK. 2. University of Manchester,UK. 3. Pakistan Institute of Learning and Living,Pakistan, andBoston University,USA. 4. Lancashire Care NHS Foundation Trust,UK. 5. Pakistan Institute of Learning and Living,Pakistan. 6. Lancashire Care NHS Foundation Trust, andUniversity of Manchester,UK. 7. Dow University of Health Sciences,Karachi,Pakistan. 8. Karachi Medical and Dental College,Pakistan.
Abstract
BACKGROUND: Research in the West shows that group psychological intervention together with an antidepressant treatment leads to more effective treatment of a depressive disorder. There are no treatment trials from low income countries comparing the efficacy of antidepressant treatment with a group psychological intervention. AIM: To conduct a feasibility trial to compare the efficacy of an antidepressant to a group psychosocial intervention, for low income women attending primary health care in Karachi, Pakistan. METHOD: This was a preliminary RCT in an urban primary health care clinic in Karachi, Pakistan. Consecutive eligible women scoring >12 on the CIS-R and >18 on Hamilton Depression Rating Scale (HDRS) (n = 66) were randomly assigned to antidepressants or a psychosocial treatment in group settings. The primary outcome measure was HDRS score; secondary outcome measures were disability and quality of life. RESULTS: More than half of the patients in both groups improved (50% reduction in HDRS scores); at end of therapy at 3 months 19 (59.4%) vs 18 (56.2%), and at 6-month follow-up 21(67.7%) vs 20(62.5%) for antidepressants and psychosocial intervention respectively. Although HDRS, BDQ and EQ5-D scores all improved considerably in both groups from start to end of treatment, and these improvements were largely maintained after a further 3 months, the differences between the two treatments were not statistically significant. CONCLUSION:Psychosocial intervention was as effective as antidepressants in reducing depression and in improving quality of life and disability at the end of therapy. However, these findings need further exploration through a larger trial.
RCT Entities:
BACKGROUND: Research in the West shows that group psychological intervention together with an antidepressant treatment leads to more effective treatment of a depressive disorder. There are no treatment trials from low income countries comparing the efficacy of antidepressant treatment with a group psychological intervention. AIM: To conduct a feasibility trial to compare the efficacy of an antidepressant to a group psychosocial intervention, for low income women attending primary health care in Karachi, Pakistan. METHOD: This was a preliminary RCT in an urban primary health care clinic in Karachi, Pakistan. Consecutive eligible women scoring >12 on the CIS-R and >18 on Hamilton Depression Rating Scale (HDRS) (n = 66) were randomly assigned to antidepressants or a psychosocial treatment in group settings. The primary outcome measure was HDRS score; secondary outcome measures were disability and quality of life. RESULTS: More than half of the patients in both groups improved (50% reduction in HDRS scores); at end of therapy at 3 months 19 (59.4%) vs 18 (56.2%), and at 6-month follow-up 21(67.7%) vs 20(62.5%) for antidepressants and psychosocial intervention respectively. Although HDRS, BDQ and EQ5-D scores all improved considerably in both groups from start to end of treatment, and these improvements were largely maintained after a further 3 months, the differences between the two treatments were not statistically significant. CONCLUSION:Psychosocial intervention was as effective as antidepressants in reducing depression and in improving quality of life and disability at the end of therapy. However, these findings need further exploration through a larger trial.
Authors: Muhammad I Husain; Imran B Chaudhry; Munir M Hamirani; Fareed A Minhas; Ajmal Kazmi; John Hodsoll; Peter M Haddad; John Fw Deakin; Nusrat Husain; Allan H Young Journal: Neuropsychiatr Dis Treat Date: 2016-12-19 Impact factor: 2.570
Authors: Nils Kappelmann; Martin Rein; Julia Fietz; Helen S Mayberg; W Edward Craighead; Boadie W Dunlop; Charles B Nemeroff; Martin Keller; Daniel N Klein; Bruce A Arnow; Nusrat Husain; Robin B Jarrett; Jeffrey R Vittengl; Marco Menchetti; Gordon Parker; Jacques P Barber; Andre G Bastos; Jack Dekker; Jaap Peen; Martin E Keck; Johannes Kopf-Beck Journal: BMC Med Date: 2020-06-05 Impact factor: 8.775
Authors: Joshua E J Buckman; Rob Saunders; Zachary D Cohen; Phoebe Barnett; Katherine Clarke; Gareth Ambler; Robert J DeRubeis; Simon Gilbody; Steven D Hollon; Tony Kendrick; Edward Watkins; Nicola Wiles; David Kessler; David Richards; Deborah Sharp; Sally Brabyn; Elizabeth Littlewood; Chris Salisbury; Ian R White; Glyn Lewis; Stephen Pilling Journal: Psychol Med Date: 2021-04-14 Impact factor: 7.723
Authors: Muhammad Omair Husain; Imran B Chaudhry; Amy Blakemore; Suleman Shakoor; Muhammad Ali Husain; Steven Lane; Tayyeba Kiran; Farhat Jafri; Rakhshi Memon; Maria Panagioti; Nusrat Husain Journal: SAGE Open Med Date: 2021-10-07
Authors: Leonardo Cubillos; Sophia M Bartels; William C Torrey; John Naslund; José Miguel Uribe-Restrepo; Chelsea Gaviola; Sergio Castro Díaz; Deepak T John; Makeda J Williams; Magda Cepeda; Carlos Gómez-Restrepo; Lisa A Marsch Journal: BJPsych Bull Date: 2021-02