Farooq Naeem1, Mirrat Gul2, Muhammad Irfan3, Tariq Munshi4, Aftab Asif5, Sadaf Rashid2, Muhammad Nasar Sayeed Khan6, Sadaf Ghani7, Azmat Malik7, Muhammad Aslam7, Saeed Farooq8, Nusrat Husain9, Muhammad Ayub10. 1. Department of Psychiatry, Queens University, Kingston, Ontario, Canada. Electronic address: farooqnaeem@yahoo.com. 2. Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, Pakistan. 3. Department of Psychiatry and Behavioural Sciences, Peshawar Medical College, Peshawar, Pakistan. 4. Department of Psychiatry, Queens University, Kingston, Ontario, Canada. 5. Department of Psychiatry and Behavioural Sciences, Mayo Hospital, Lahore, Pakistan. 6. Department of Psychiatry, Services Hospital, Lahore, Pakistan. 7. Pakistan Association of Cognitive Therapists, Pakistan. 8. Department of Psychiatry, PGMI Lady Reading Hospital Peshawar, Pakistan; Staffordshire University, UK. 9. Institute of Brain, Behaviour and Mental Health, University of Manchester, UK. 10. Department of Developmental Disabilities, Queens University, Kingston, Ontario, Canada.
Abstract
OBJECTIVES: To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU)-delivered by trained therapists using a manual compared with alone TAU. METHODS: This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them toCaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. FINDINGS: A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. CONCLUSION:Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings.
RCT Entities:
OBJECTIVES: To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU)-delivered by trained therapists using a manual compared with alone TAU. METHODS: This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them to CaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. FINDINGS: A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. CONCLUSION: Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings.
Authors: Atif Rahman; Fareed Aslam Minhas; Syed Usman Hamdani; Zainab Ahmed; Marit Sijbrandij; Huma Nazir; Aqsa Masood; Parveen Akhtar; Hania Amin; Richard A Bryant; Katie Dawson; Mark van Ommeren Journal: Int J Ment Health Syst Date: 2017-06-08
Authors: Muhammad Ishrat Husain; Imran B Chaudhry; Raza R Rahman; Munir M Hamirani; Nasir Mehmood; Peter M Haddad; John Hodsoll; Allan H Young; Farooq Naeem; Nusrat Husain Journal: Int J Bipolar Disord Date: 2017-02-11