Group interpersonal psychotherapy for depression in rural Uganda - A randomized controlled trial
Group interpersonal psychotherapy for depression in rural Uganda - A randomized controlled trial
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DOI：
10.1001/jama.289.23.3117
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发表时间：
2003-06-18
影响因子：
120.7
通讯作者：
Weissman, M
中科院分区：
文献类型：
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作者：
Bolton, P;Bass, J;Weissman, M
尽管精神疾病在非洲很重要，但与此问题相关的对照干预试验很少发表。目的检验团体人际心理治疗在缓解抑郁和功能障碍方面的疗效，评价在非洲开展对照试验的可行性。设计、环境和参与者本群随机对照临床试验（2002年2月至6月）采用随机程序选择了乌干达农村Masaka和Rakai地区的30个村庄；然后随机分配15名男性和15名女性作为研究对象。在每个村庄，使用当地改编的霍普金斯症状检查表和工具评估功能对自认为和其他村民患有抑郁症样疾病的成年男子或妇女进行访谈。根据这些访谈，为每个村庄创建了341名符合《精神障碍诊断与统计手册》第四版（DSM-IV）重度抑郁症或亚综合征性抑郁症标准的男性和女性的名单。采访者按照症状严重程度的递减顺序重新访问，直到每个村有8 - 12人，共计284人。其中，248人同意参加审判，9人拒绝；其余的人死亡或搬迁。共有108名男性和116名女性完成了这项研究，并接受了再次采访。15个男性村中的8个和15个女性村中的7个被随机分配到干预组，其余的被分配到对照组。干预村接受了针对抑郁症的群体人际心理治疗，每周90分钟，持续16周。主要结局测量：抑郁和功能障碍严重程度评分采用适用于当地使用的量表；符合DSM-IV重度抑郁症诊断标准的人的比例。结果干预组抑郁严重程度平均降低17.47分，对照组平均降低3.55分（P < 0.05）
Context Despite the importance of mental illness in Africa, few controlled intervention trials related to this problem have been published.Objectives To test the efficacy of group interpersonal psychotherapy in alleviating, depression and dysfunction and to evaluate the feasibility of conducting controlled trials in Africa.Design, Setting, and Participants For this cluster randomized, controlled clinical trial (February-June 2002), 30 villages in the Masaka and Rakai districts of rural Uganda were selected using a random procedure; 15 were then randomly assigned for studying men and 15 for women. In each village, adult men or women believed by themselves and other villagers to have depressionlike illness were interviewed using a locally adapted Hopkins Symptom Checklist and an instrument assessing function. Based on these interviews, lists were created for each village totaling 341 men and women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depression or subsyndromal depression. Interviewers revisited them in order of decreasing symptom severity until they had 8 to 12 persons per village, totaling 284. Of these, 248 agreed to be in the trial and 9 refused; the remainder died or relocated. A total of 108 men and 116 women completed the study and were reinterviewed.Intervention Eight of the 15 male villages and 7 of the 15 female villages were randomly assigned to the intervention arm and the remainder to the control arm. The intervention villages received group interpersonal psychotherapy for depression as weekly 90-minute sessions for 16 weeks.Main Outcome Measures Depression and dysfunction severity scores on scales adapted and validated for local use; proportion of persons meeting DSM-IV major depression diagnostic criteria.Results Mean reduction in depression severity was 17.47 points for intervention groups and 3.55 points for controls (P