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Group Interpersonal Psychotherapy Effective for Depression in Study of Uganda Population

A new study by researchers at the New York State Psychiatric Institute and Columbia University found that a group interpersonal therapy (IPT-G) model for depression was effective in reducing depression and dysfunction in a group of individuals in HIV-prone Uganda. The results are published in the June 18th issue of the Journal of the American Medical Association.

HIV has ravaged portions of Africa and Uganda bears a substantial mental health burden. According to the authors, a community-based survey done in 2000 in an impoverished part of southwest Uganda found that 21% of the population suffered from major depression. The investigators set out to study effective methods of treating this population. Though patients in other countries have responded well to both antidepressants and psychotherapy, the researchers were concerned that these treatments would be inapplicable in Uganda because of the high cost of antidepressants and certain cultural constraints.
IPT-G was chosen because it focuses on coping with interpersonal problems through group discussion, which fits the Ugandan culture.

Moreover, a number of clinical trials support its efficacy for depression. The interpersonal therapy model was originally developed by Dr. Myrna Weissman, Director of Clinical and Genetic Epidemiology at the New York State Psychiatric Institute (NYSPI) at Columbia University and one of the study’s authors. She, along with Dr. Lena Verdeli and Ms. Kathleen Clougherty, modified the treatment for Uganda. Dr. Verdeli and Ms. Clougherty went to Uganda and trained the health workers, who administered the treatment.

Of 30 villages in rural Uganda, 15 were randomly assigned to study men and 15 to women. Eight of the 15 male villages and 7 of the 15 female villages received IPT-G and the rest were the control group. The people in the villages chosen to receive the therapy were given weekly 90-minute sessions for 16 weeks. A total of 108 men and 116 women completed the study. Prior to treatment, 86% of those in the IPT-G group qualified for major depression compared to 94% of those in the control group. Following treatment, only 6.5% of the IPT-G group had depression symptoms compared to 54.7% of the control group.
“We now know,” said Dr. Weissman, “that we can conduct clinical trials of psychotherapy in sub-Saharan Africa. This study also shows the universality of depression. The very same triggers—like the death of a loved one, family disputes and life changes—found in the U.S. were found in Uganda as well.”
Drs. Richard Neugebauer and Priya Wickramaratne of NYSPI and Columbia were also involved in the design and analysis of IPT in Uganda.

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