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Preliminary Evaluation of Culturally Sensitive CBT for Depression in Pakistan: Findings from Developing Culturally-Sensitive CBT Project (DCCP)

  • Farooq Naeem (a1), Waquas Waheed (a2), Mary Gobbi (a1), Muhammad Ayub (a3) and David Kingdon (a1)...

Abstract

Background: There is sufficient research evidence in favour of cognitive therapy in western world. However, only limited research has been carried out on its effectiveness in other countries. It is suggested that adaptations in content, format and delivery are needed before CBT can be employed in non-western cultures. We describe a preliminary evaluation of culturally adapted CBT for depression in Pakistan. Aims: We aimed to evaluate the efficacy of this culturally adapted CBT using a therapist manual. Method: In a randomized controlled trial we compared combination of CBT and antidepressants with antidepressants alone (treatment as usual) in primary care. Referred patients with ICD-10 diagnosis of depression were invited to participate and randomized to the intervention and control groups. Hospital Anxiety and Depression Scale (HADS) and Bradford Somatic Inventory (BSI) were used to measure changes in depression, anxiety and somatic symptoms. Results: Seventeen patients each were randomized to each arms of the trial. Except for financial status there were no differences between the two groups on various demographic variables. Patients receiving CBT showed statistically significant improvement on measures of depression (p < .001), anxiety (p < .001) and somatic symptoms (p < .000) as compared to antidepressant alone group. 82% patients attended six or more sessions of therapy. Conclusions: A culturally sensitive manualized CBT was effective in reducing symptoms of depression and anxiety in Pakistan.

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Corresponding author

Reprint requests to Farooq Naeem, Department of Psychiatry, University of Southampton, Southampton SO14 3ED, UK. E-mail: farooqnaeem@yahoo.com

References

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Agnes, C., Mei-chun, C., Wilson, T., Sophia, S. and Dejian, S. (2009). Dejian mind-body intervention on depressive mood of community-dwelling adults: a randomized controlled trial. eCAM; 1 of 8
Araya, R., Rojas, G., Fritsch, R., Gaete, J., Rojas, M., Simon, G. and Peters, T. (2003). Treating depression in primary care in low-income women in Santiago, Chile: a randomized controlled trial. Lancet, 361 (9362), 9951000.
Barrera, M. and Castro, F. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology Science Practice, 13, 311316.
Hall, G. (2001). Psychotherapy research with ethnic minorities: empirical, ethical, and conceptual issues. Journal of Consulting and Clinical Psychology, 69, 502510.
Mirza, I. and Jenkins, R. (2004). Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. British Medical Journal, 3, (7443), 794.
Moher, D., Schulz, K. F. and Altman, D. G. (2001). The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. Lancet, 357 (9263), 11911194.
Mumford, D. B., Tareen, I. A., Bajwa, M. A., Bhatti, M. R. and Karim, R. (1991). The translation and evaluation of an Urdu version of the Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia, 83, 8185.
Mumford, D. B., Bavington, J. T., Bhatnagar, K. S., Hussain, Y., Mirza, S., Naraghi, M. M. (1991). The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. British Journal of Psychiatry, 158, 379–86
Naeem, F. (2005). Five months back in Pakistan: clinical reflections. Psychiatric Times, November, 43–44.
Naeem, F., Gobbi, M., Ayub, M. and Kingdon, D. (2010). Psychologists' experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan. International Journal of Mental Health Systems, 4, 2.
Naeem, F., Gobbi, M., Ayub, M. and Kingdon, D. (submitted). What do depressed patients in Pakistan think about their illness, its causes and its treatment (especially psychotherapy)?
Naeem, F., Gobbi, M., Ayub, M. and Kingdon, D. (2009). University students' views about compatibility of cognitive behaviour therapy (CBT) with their personal, social and religious values (a study from Pakistan). Mental Health Religion and Culture. 12, 847855.
Naeem, F., Ayub, M., Gobbi, M. and Kingdon, D. (2009). Development of Southampton Adaptation Framework for CBT (SAF-CBT): a framework for adaptation of CBT in non-western culture. Journal of the Pakistan Psychiatric Society, 6, 7984.
National Institute for Health and Clinical Excellence (2004). Depression: management of depression in primary and secondary care. NICE clinical guideline 23. London: NICE.
Padesky, C. and Greenberger, D. (1995). Clinicians Guide to Mind over Mood. New York: The Guilford Press.
Rahman, A., Malik, A., Sikander, S., Roberts, C. and Creed, F. (2008). Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomized controlled trial. Lancet, 372 (9642), 902909.
Rossello, J., Bernal, G. and Rivera-Medina, C. (2008). Individual and group CBT and IPT for Puerto Rican adolescents with depressive symptoms, cultural diversity and ethnic Minority Psychology, 14, 234245.
Sumathipala, A., Siribaddana, S., De Silva, P., Dewey, M., Prince, M. and Mann, A. H. (2008). Cognitive-behavioural therapy v. structured care for medically unexplained symptoms: randomized controlled trial. British Journal of Psychiatry, 193, 5159.
Wen-Shing, Tseng (2004). Culture and psychotherapy: Asian perspectives. Journal of Mental Health, 13, 151161.
Wong, D. F. (2008). Cognitive behavioral treatment groups for people with chronic depression in Hong Kong: a randomized wait-list control design. Depression and Anxiety, 25, 142148.
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Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
  • URL: /core/journals/behavioural-and-cognitive-psychotherapy
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Preliminary Evaluation of Culturally Sensitive CBT for Depression in Pakistan: Findings from Developing Culturally-Sensitive CBT Project (DCCP)

  • Farooq Naeem (a1), Waquas Waheed (a2), Mary Gobbi (a1), Muhammad Ayub (a3) and David Kingdon (a1)...
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