School-based group interpersonal therapy for adolescents with depression in rural Nepal: a mixed methods study exploring feasibility, acceptability, and cost.

Autor:	Rose-Clarke K; Department of Global Health and Social Medicine, King's College London, London, UK., B K P; Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal., Magar J; Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal., Pradhan I; Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal., Shrestha P; Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal., Hassan E; Department of Global Health and Social Medicine, King's College London, London, UK., Abou Jaoude GJ; Institute for Global Health, University College London, London, UK., Haghparast-Bidgoli H; Institute for Global Health, University College London, London, UK., Devakumar D; Institute for Global Health, University College London, London, UK., Carrino L; Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy., Floridi G; Leverhulme Centre for Demographic Science, University of Oxford, Oxford, UK., Kohrt BA; Department of Psychiatry, George Washington University, Washington, DC, USA., Verdeli H; Teachers College, Columbia University, New York, NY, USA., Clougherty K; Psychological Services, Ruth and Allen Ziegler Student Services, Tel Aviv University, Tel Aviv, Israel., Klein Rafaeli A; Psychological Services, Ruth and Allen Ziegler Student Services, Tel Aviv University, Tel Aviv, Israel., Jordans M; Centre for Global Mental Health, King's College London, London, UK., Luitel NP; Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal.
Jazyk:	angličtina
Zdroj:	Global mental health (Cambridge, England) [Glob Ment Health (Camb)] 2022 Aug 22; Vol. 9, pp. 416-428. Date of Electronic Publication: 2022 Aug 22 (Print Publication: 2022).
DOI:	10.1017/gmh.2022.46
Abstrakt:	Background: Adolescents with depression need access to culturally relevant psychological treatment. In many low- and middle-income countries treatments are only accessible to a minority. We adapted group interpersonal therapy (IPT) for adolescents to be delivered through schools in Nepal. Here we report IPT's feasibility, acceptability, and cost. Methods: We recruited 32 boys and 30 girls (aged 13-19) who screened positive for depression. IPT comprised of two individual and 12 group sessions facilitated by nurses or lay workers. Using a pre-post design we assessed adolescents at baseline, post-treatment (0-2 weeks after IPT), and follow-up (8-10 weeks after IPT). We measured depressive symptoms with the Depression Self-Rating Scale (DSRS), and functional impairment with a local tool. To assess intervention fidelity supervisors rated facilitators' IPT skills across 27/90 sessions using a standardised checklist. We conducted qualitative interviews with 16 adolescents and six facilitators post-intervention, and an activity-based cost analysis from the provider perspective. Results: Adolescents attended 82.3% (standard deviation 18.9) of group sessions. All were followed up. Depression and functional impairment improved between baseline and follow-up: DSRS score decreased by 81% (95% confidence interval 70-95); functional impairment decreased by 288% (249-351). In total, 95.3% of facilitator IPT skills were rated superior/satisfactory. Adolescents found the intervention useful and acceptable, although some had concerns about privacy in schools. The estimate of intervention unit cost was US $96.9 with facilitators operating at capacity. Conclusions: School-based group IPT is feasible and acceptable in Nepal. Findings support progression to a randomised controlled trial to assess effectiveness and cost-effectiveness. (© The Author(s) 2022.)
Databáze:	MEDLINE
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