Study of Treatments for Depression Among Displaced Adolescents in Northern Uganda.
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      That interpersonal psychotherapy and creative play therapies can reduce symptoms of
      depression among adolescents with depressive-type illness in northern Uganda.
    

Detailed description: 
      This study represents the third phase of a project aimed at developing, validating, and using
      locally-relevant assessments of emotional and behavioral problems in Acholi war-affected
      children to evaluate interventions being delivered by non-governmental organizations in the
      N. of Uganda. It is positioned to make a unique contribution to the field by both developing
      culturally appropriate screening and assessment methods and then using them to assess the
      efficacy of an adapted, manualized treatment both pre-and post-intervention.

      The intent of the proposed intervention study is to test the efficacy of group interpersonal
      psychotherapy (IPT) for treatment of specific psychosocial problems and associated impairment
      in Acholi IDP adolescents living in the Unyama and Awer camps of Gulu District, Northern
      Uganda. These interventions represent the existing standard of care provided by NGOs working
      in this region, but. for tje first time, collaboration of the NGOs in this study will help
      ensure systematic assessment of participants to investigate the efficacy of interventions
      being offered.

      The proposed research study aims to test the efficacy of a group treatment for emotional and
      behavioral problems in war-affected adolescents. Emotional and behavioral problems will be
      assessed using a locally-validated scale of psychosocial problems and functional impairment
      developed from ethnographic work conducted in the same IDP camps in Gulu District in July
      2004. The intervention to be tested will be group interpersonal therapy (IPT) which has shown
      efficacy for use in treating depression in Ugandan adults In Masaka and Rakai provinces. The
      decision to use IPT in this IDP population was based on the fact that symptoms similar to
      depression and comorbid anxiety, for which IPT is indicated, dominated in the ethnographic
      assessment of emotional and behavioral problems collected in July. Additionally, we have
      prior direct experience in Uganda that IPT can be easily trained and systematically delivered
      in a low-resource environment lay practitioners and that it is effective in treating
      depression. Furthermore, our ethnographic work has resulted in a suitable measure for
      assessing emotional and behavioral problems in war- affected Acholi youth living in the
      Northern Uganda for use in screening adolescents into intervention groups. The application of
      valid instruments to assess psychosocial problems and the degree of impairment both pre and
      post- intervention will be invaluable to our implementing partners - World Vision/War Child -
      for developing effective interventions to address the ongoing mental health needs of the
      young people they serve in Northern Uganda.

      Specific Objectives 1. To assess symptoms of locally described depression-like syndromes
      (Kumu/Par/Two Tam), a local anxiety syndrome (Ma Lwor) and social problems (Gin lugero/tic
      marac) in Acholi war-affected adolescents using the Acholi Psychosocial Assessment Instrument
      (APAI), a locally-derived tool for assessment of emotional and behavioral problems in
      children and youth available in the Luo language.

      2. To randomly assign screened individuals found to have these problems to one of three
      treatment conditions including: a) group IPT; b) a facilitated arts & recreation control
      condition; and c) a wait-list control condition.

      3. To conduct post-intervention testing and comparison of all treatment conditions using the
      APAI. This will be done immediately after the IPT intervention is completed, and repeated 6
      months later.
    

Intervention name(s): interpersonal psychotherapy for groups; creative play therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): psychotherapy; consisted of play activities
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: randomized controlled trial; depression; Uganda; adolescents