Brief Culturally adapted CBT (CaCBT) for depression: A randomized controlled trial from Pakistan

Naeem, Farooq; Gul, Mirrat; Irfan, Muhammad; Munshi, Tariq; Asif, Aftab; Rashid, Sadaf; Khan, Muhammad Nasar Sayeed; Ghani, Sadaf; Malik, Azmat; Aslam, Muhammad; Farooq, Saeed; Husain, Nusrat; Ayub, Muhammad

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 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.

Citation

Naeem, F., Gul, M., Irfan, M., Munshi, T., Asif, A., Rashid, S., …Ayub, M. (2015). Brief Culturally adapted CBT (CaCBT) for depression: A randomized controlled trial from Pakistan. Journal of Affective Disorders, 177, 101-107. https://doi.org/10.1016/j.jad.2015.02.012

• Journal Article Type: Article
• Publication Date: May 15, 2015
• Deposit Date: Nov 29, 2023
• Journal: Journal of Affective Disorders
• Print ISSN: 0165-0327
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 177
• Pages: 101-107
• DOI: https://doi.org/10.1016/j.jad.2015.02.012
• Keywords: Psychiatry and Mental health; Clinical Psychology; Cognitive; Behaviour; Therapy; Depression; Adaptation; Pakistan
• Public URL: https://keele-repository.worktribe.com/output/651395
• Additional Information: This article is maintained by: Elsevier; Article Title: Brief Culturally adapted CBT (CaCBT) for depression: A randomized controlled trial from Pakistan; Journal Title: Journal of Affective Disorders; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jad.2015.02.012; Content Type: article; Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.