Please select the eligibility criteria that correspond to the clinical trial below.
Title: INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) Study
Brief Summary: To provide better care and preventive services for people with both depression and diabetes, the investigators propose to develop and test whether interventions to reduce depressive symptoms can be integrated into routine diabetes clinics in India. The investigators will gather feedback from patients in India through focus group discussions and individual interviews so they can culturally-adapt a model of combined depression and diabetes care. The investigators will then evaluate the effectiveness and costs of this care model in a trial at four diabetes clinics in India. It is expected that results from this study can guide how to incorporate mental health care into routine diabetes clinics in low-resource settings.


Options:
A: Inclusion Criteria:

* Age ≥ 16
* GHQ-12 ≥ 6
* Willing to participate in the intervention and research program
* Able to communicate fluently in Nepali and to participate the required visits
* Resident in Dang for the subsequent 10 months

Exclusion Criteria:

* Age \< 16
* GHQ-12 \< 6
* Signs of severe mental health problems (i.e., psychotic features)
* Severe illnesses or conditions requiring immediate attentions( i.e., suicidal)
* Not willing to participate in the intervention and research program
B: Inclusion Criteria:

* Age ≥35 years
* Confirmed diagnosis of diabetes (documented glucose tolerance test or 2 venous glucose levels)
* PHQ-9 score≥10
* ≥1 poorly-controlled CVD risk factor (either HbA1c≥8.0% or SBP≥140 mmHg or LDL≥130 mg/dl), irrespective of medications used
* Willingness to consent to randomization.

Exclusion Criteria:

* The patient reports a "3" on the PHQ-9 questionnaire suicide item (Item No:9) which reflects very high suicide risk or the patient's PHQ-9 score is above 23 indicating severe depression requiring immediate referral
* Any participant reporting a "2" on the PHQ-9 suicide item (Item No:9) will be reviewed carefully and if considered too high risk, the participant will be excluded from enrollment in the trial and referred for more intensive psychiatric care.
* Already in psychiatrist's care or using antipsychotic or mood stabilizer medication or diagnosed dementia or bipolar disorder or schizophrenia (based on bipolar and schizophrenia modules of the MINI)
* Diabetes secondary to uncommon causes (e.g., chronic pancreatitis)
* Pregnancy or breastfeeding
* Documented CVD event (MI, stroke) in past 12 months
* End-stage renal disease awaiting transplant
* Malignancy or life-threatening disease with death probable in 3 years
* Alcohol or drug abuse
* No fixed address or contact details.
C: Once youth are referred to the study, a screening tool will be administered to determine whether or not they meet eligibility requirements as described below.

The screening tool contains four sections;

1. Consent and Age: assures that participants meet the age requirements
2. Oxford Refugees Psychosocial Adjustment Scale: assesses depression, anxiety and hostility
3. Functioning: assesses the participant's ability to carry out activities of daily living
4. Psychological Analysis: clinician's assessment of the psychological state of the participant.

Inclusion Criteria:

* Participants must be between 15-24 years of age;
* Participants must prefer to have the opportunity to join an educational program but not currently be enrolled in school;
* A participant's total score on the Oxford scale must equal or exceed 30 AND
* Participants must display at least one non-zero score on the functioning questions.

Exclusion Criteria:

* Participant does not plan to reside in the Freetown urban area for the duration of the study (9 months from start date);
* Participant fails to meet age requirements;
* Participant is currently enrolled in school;
* Participant is not in favor of joining an educational program;
* Participant fails to meet Oxford psychosocial or functioning thresholds;
* Participant is judged by clinical staff as:

  * Needing mental health treatment beyond the scope of the YRI
  * Otherwise not suitable for a group treatment setting
* Participant displays the following:

  * Cognitive delays
  * Active suicidality
  * Psychosis
  * Risk of harm to themselves or others

Participants at risk of harm to themselves or others, as well as those requiring treatment beyond the scope of the YRI, will be referred to local mental health or social work treatment facilities as appropriate.
D: Inclusion Criteria:

* minimum age 18
* HIV infected outpatient enrolled in 1 of 5 AMPATH clinics
* drank alcohol in past month
* hazardous or binge drinker (AUDIT-C)
* lives within an hour of Eldoret HIV clinic
* verbal working knowledge of Kiswahili

Exclusion Criteria:

* active psychosis, suicidality or severe cognitive impairment
* physically unable to attend session
* previous participation in CBT study

Answer: B