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Group therapy improves depression outcomes among adults with HIV

Group support psychotherapy significantly improved depression outcomes among patients with HIV and depression in northern Uganda, according to study findings in The Lancet HIV.

“HIV/AIDS is no longer thought of as a terminal illness, but rather as a chronic disease. Therefore, clinical practice and research should focus on helping patients and caregivers to learn how to cope with the challenges of living with a chronic disease,” study researcher Etheldreda Nakimuli-Mpungu, PhD, of Makerere University in Uganda, and colleagues wrote. “One such challenge is mental ill health, which has been consistently associated with HIV infection, with depression being the most common mental health problem in people with HIV/AIDS worldwide.”

To assess the effects of group psychotherapy, researchers compared it with group HIV education directly after treatment and during follow-up six months later. Fifty-seven patients aged 19 years or older with HIV and depression were randomly assigned to group psychotherapy and 52 were assigned to group HIV education. All study participants met Mini International Neuropsychiatric Interview criteria for major depression. Group psychotherapy consisted of 8 weekly sessions that were 2 to 3 hours long. Participants were divided into gender-specific groups for psychotherapy. Group sessions occurred from January through March 2014. Follow-up assessments were conducted in September 2014.

During intervention, participants in both groups had similar reductions in depression symptoms and therefore had no difference in mean depression scores at assessment immediately after intervention. However, participants who received group psychotherapy had greater reductions in depression symptoms and lower mean depression scores at 6-month follow-up compared with participants in the education group.

Participants in both groups experienced similar improvements in perceived social support and self-esteem immediately after intervention. Though, participants who received group psychotherapy had greater improvements in both measures at follow-up vs. participants who received group HIV education.

“The benefits of existing HIV educational and adherence counseling interventions in HIV care services could be improved with the addition of [group psychotherapy] content in view of the high prevalence of depression in people living with HIV/AIDS in Uganda,” Nakimuli-Mpungu and colleagues wrote.

In an accompanying editorial, researchers from Brigham and Women’s Hospital discussed a number of questions they felt the study findings raised, including how models of psychological treatments for common mental disorders could be applied in low- and middle-income countries and what the findings mean for other aspects of health and well-being.

“More research like the study by Nakimuli-Mpungu and colleagues will help spur an effective response to the nearly decade-old call for action issued in the 2007 Lancet series on global mental health,” Ingrid T. Katz, MD, and Alexander C. Tsai, MD, PhD, wrote. “Programmatic work to optimize scale-up treatments for mental disorders in low-income and middle-income countries is, now more than ever, urgently needed to address one of the most neglected aspects of human health and well-being.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.