Effect of a Primary Care–Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe

Chibanda, Dixon; Weiss, Helen A.; Verhey, Ruth; Simms, Victoria; Munjoma, Ronald; Rusakaniko, Simbarashe; Chingono, Alfred; Munetsi, Epiphania; Bere, Tarisai; Manda, Ethel; Abas, Melanie; Araya, Ricardo

doi:10.1001/jama.2016.19102

Cited by 333 publications

(342 citation statements)

References 32 publications

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“…These findings are in line with earlier findings where interpersonal violence was reported by more than 40% of those presenting with CMDs and receiving the Friendship Bench intervention (Chibanda et al, 2016). Experiencing domestic violence has been found to be an important trauma type associated with PTSD and CMDs (Kaminer, Grimsrud, Myer, Stein, & Williams, 2008; Schumm, Briggs-Phillips, & Hobfoll, 2006).…”

Section: Discussionsupporting

confidence: 93%

“…To decrease the burden of mental illness, an evidence-based approach, such as the Friendship Bench programme, can easily be offered in all PHC facilities as it has been shown to offer an efficient and cost-effective as well as culturally acceptable way to bridge the existing treatment gap (Chibanda et al, 2016). However, there is a need to address the comorbidity that is often found (O’Donnell, Creamer, & Pattison, 2004), particularly at the PHC level (Campbell et al, 2007; Herman et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…As in an earlier study (Chibanda et al, 2016), data were entered directly into the study desktop computer by a data-entry clerk using a predesigned data-entry program containing automated range checks, and data cleaning was carried out at the end of each day. Data were transferred to STATA version 13.0 for analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Psychosocial interventions such as the Friendship Bench (Chibanda et al, 2011, 2016) seem to reduce the perception of lack of control among affected populations (Miller & Rasmussen, 2010). The Zimbabwean Friendship Bench programme is a low-intensity psychological intervention that is successfully reducing the treatment gap for CMDs at the primary health-care (PHC) level.…”

Section: Introductionmentioning

confidence: 99%

“…The Zimbabwean Friendship Bench programme is a low-intensity psychological intervention that is successfully reducing the treatment gap for CMDs at the primary health-care (PHC) level. The task-shifted intervention is delivered by trained and supervised lay health workers (LHWs) (Chibanda et al, 2016). There is a dearth of data on cultural understandings of trauma as well as on the societal and psychological impacts of low- versus high-intensity stressors and their influence on potential treatment considerations of subsequent PTSD, and therefore rigorous research is needed.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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Background: We investigated the prevalence of and factors associated with post-traumatic stress disorder (PTSD) and common mental disorders (CMDs), which include depression and anxiety disorders, in a setting with a prevalence of high human immunodeficiency virus (HIV) within a primary care clinic, using the PTSD Checklist for DSM-5 and the 14-item Shona Symptom Questionnaire, both locally validated screening tools.Methods: A cross-sectional survey was carried out with adult patients (n = 204) from the largest primary care clinic facility in Harare, Zimbabwe, in June 2016.Results: A total of 83 patients (40.7%) met the criteria for probable PTSD, of whom 57 (69.5%) had comorbid CMDs. Among people living with HIV, 42 (55.3%) had PTSD. Probable PTSD was associated with having experienced a negative life event in the past 6 months [adjusted odds ratio (OR) 3.73, 95% confidence interval (CI) 1.49–9.34] or screening positive for one or more CMD (adjusted OR 6.48, 95% CI 3.35–2.54).Conclusion: People living with HIV showed a high prevalence of PTSD and CMD comorbidity. PTSD screening should be considered when the CMD screen is positive and there is a history of negative life events.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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Randomized Clinical Trials to Evaluate Mental Health Interventions in Resource-Poor Societies

Neugebauer

2016

JAMA

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Work on global mental health and on the global burden of disease has documented the immense gap between mental health need and mental health services. Three-quarters of the burden of mental disorders occurs in low-and middle-income countries, yet these countries are the least able to respond effectively to address these disorders. 1 In many parts of the world, this gap between mental health needs and available services exceeds 70%; in very-low-income countries this figure is closer to 90%. 1 One strategy for addressing this problem has received considerable attention: the crafting of psychological interventions that can be taught to lay health care workers in low-and middle-income societies.In this issue of JAMA, 2 randomized clinical trials (RCTs)-one from war-affected Pakistan 2 and the other from Zimbabwe 3 -evaluated the effectiveness of this strategy. These trials were conducted by internationally recognized contributors to this field and exemplify the increasing commitment to sustained, scientifically rigorous research on effective, implementable methods for alleviating the substantial mental health burden in resource-poor societies.The trial by Rahman et al 2 compared the effect of 5 weeks of manualized, multidimensional behavioral intervention vs enhanced usual care for symptoms of depression and anxiety, with the intervention delivered by lay health workers in 3 primary care clinics in Peshawar, Pakistan. The trial included 346 adults (mean age, 33 years; range, 18-60 years, 80% women, and 60% with no formal education) allocated randomly in a 1:1 ratio to the 2 trial groups. The intervention included evidence-based problem-solving and behavioral methods provided in individual 90-minute weekly sessions. The guiding approach was viewed as "transdiagnostic," ie, it addressed symptoms occurring across a variety of conditions rather than symptoms pathognomonic of a particular disorder. The primary outcome measures were scores on the continuous Hospital Anxiety and Depression Scale (HADS) 4 overall and the HADS anxiety and depression subscales, assessed at 3 months after start of treatment.The cluster randomized trial by Chibanda et al, 3 conducted in Harare, Zimbabwe, compared the effect of a manualized multimodality intervention vs enhanced usual care for symptoms of common mental disorders with treatment delivered in 6 weekly sessions by lay health workers in 24 primary care clinics. This trial included 573 adults (median age, 33 years; 86% women, 50% had completed primary education, and 42% were HIV positive). The clinics were allo-16. Patel V, Weobong B, Nadkarni A, et al. The effectiveness and cost-effectiveness of lay counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India: PREMIUM study protocol for randomized controlled trials. Trials. 2014;15:101-110.

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Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru

Araya

Menezes

Claro

et al. 2021

JAMA

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IMPORTANCEDepression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low-and middle-income countries, but the effectiveness in these countries is unknown.OBJECTIVE To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with diabetes and/or hypertension. DESIGN, SETTING, AND PARTICIPANTSParticipants with clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score Ն10) who were being treated for hypertension and/or diabetes were enrolled in a cluster randomized clinical trial (RCT) at 20 sites in

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Effect of a Primary Care–Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe

Cited by 333 publications

References 32 publications

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Randomized Clinical Trials to Evaluate Mental Health Interventions in Resource-Poor Societies

Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru

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