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Randomized Trial Shows Culturally Sensitive Group Support Psychotherapy Reduces Symptoms of Depression Among People Living With HIV/AIDS in Uganda

April 01, 2015 - Totonto, Canada - Grand Challenges Canada, funded by the Government of Canada, congratulates innovator Dr. Etheldreda Nakimuli-Mpungu, Senior Lecturer in the Department of Psychiatry at Makerere University (Uganda), with regards to her study to treat major depression among people living with HIV/AIDS. The results of her study are published today in The Lancet HIV.

In 2012, Makerere University received a seed grant from Grand Challenges Canada to develop and test a culturally sensitive group support psychotherapeutic (GSP) intervention to treat major depression among people living with HIV/AIDS in northern Uganda.

With Canada's support, Dr. Nakimuli-Mpungu led a team of international researchers, including Dr. Edward Mills of the University of Ottawa. Their randomized clinical trial showed that the treatment of major depression with GSP resulted in a significant reduction in depression symptoms and increased function levels, self-esteem and social support in people living with HIV in northern Uganda.

This study is the first randomized controlled trial in sub-Saharan Africa that compares a group psychotherapeutic intervention with an active comparison group intervention, in an attempt to control for the effects of common therapeutic factors.

Participants received eight weekly sessions of either group support psychotherapeutic interventions (GSP) or group HIV education (GHE), and were followed up immediately after the intervention and again six months after the end of the treatment.

During the treatment period, both groups showed a similar reduction in depression symptoms and a similar increase in function level, self-esteem and social support. However, six months after the intervention, the GSP group had a greater reduction in depression symptoms, which resulted in lower mean depression scores. The numbers also indicated that GSP was effective in improving function levels among participants. Further, the GSP group had a greater increase in perceived social support and self-esteem than did those in the GHE group.

Dr. Nakimuli-Mpungu said, "Group Support Psychotherapy will decrease the symptoms of depression and increase livelihood strategies with people. This leads to the acquisition of livelihood assets and thus helps to restore the dignity and independence of those affected by depression, leading to a sustained reduction in depression and an increase in functionality."

The outcomes stress the need for a comprehensive HIV care model that integrates mental health care into the overall medical regimen. This groundbreaking work opens the door to studying the effectiveness of GSP in other susceptible populations and to training lay community health workers to deliver GSP, thereby increasing accessibility to the intervention for those residing in rural areas.

Dr. Edward Mills of the University of Ottawa and a co-author of the paper said, "Ideas such as those of Dr. Nakimuli-Mpungu represent important steps forward for global health, as they are both culturally relevant and scientifically credible. Expansion of this model in similar settings may improve HIV-related clinical outcomes and improve the patient's quality of life."

Depression is the leading cause of disability worldwide, with more than 350 million people suffering globally. Seventy-five percent of sufferers are likely to be living in resource-poor areas, and 85 percent of these people are unlikely to be receiving any treatment.

Canada, through Grand Challenges Canada, is a world leader in global mental health innovation in low- and middle-income countries. To date, our total investment is over $32 million, supporting 63 projects, including 8 Transition-to-Scale investments and the development of the Mental Health Innovation Network.

Dr. Karlee Silver, VP Targeted Challenges of Grand Challenges Canada, said, "A country needs human capital; individuals who are productive members of society. This innovative model helps people coping with HIV/AIDS to regain their dignity, self-esteem and desire to fully participate and contribute to their communities."

Dr. Peter Singer, Chief Executive Officer of Grand Challenges Canada, said, "Canada is proud to support this great example of how a Bold Idea can have a Big Impact in global mental health. Not only is this the first randomized controlled trial of this kind for sub-Saharan Africa, the approach proves to be highly effective against major depression in people living with HIV/AIDS."

For the full paper by Dr. Nakimuli-Mpungu, visit: .

For more information about Grand Challenges Canada's Global Mental Health challenge, visit our website and look for us on Facebook, Twitter, YouTube and LinkedIn.

About Grand Challenges Canada
Grand Challenges Canada is dedicated to supporting Bold Ideas with Big Impact ® in global health. We are funded by the Government of Canada; we support innovators in low- and middle-income countries and Canada. The bold ideas we support integrate science and technology, social and business innovation to find sustainable solutions to health challenges - we call this Integrated Innovation ® . Grand Challenges Canada focuses on innovator-defined challenges through its Stars in Global Health program and on targeted challenges in its Saving Lives at Birth, Saving Brains and Global Mental Health programs. Grand Challenges Canada works closely with Canada's International Development Research Centre (IDRC), the Canadian Institutes of Health Research (CIHR) and the Department of Foreign Affairs, Trade and Development Canada (DFATD) to catalyze scale, sustainability and impact. We have a determined focus on results, and on saving and improving lives.

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