Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-22T06:40:35.285Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  19 November 2010

Farooq Naeem ,
Waquas Waheed ,
Mary Gobbi ,
Muhammad Ayub  and
David Kingdon
Farooq Naeem*
Affiliation:
University of Southampton, UK
Waquas Waheed
Affiliation:
University Department of Psychiatry, Preston, UK
Mary Gobbi
Affiliation:
University of Southampton, UK
Muhammad Ayub
Affiliation:
Tees, Esk and Wear Valley NHS Foundation Trust, Middlesbrough, UK
David Kingdon
Affiliation:
University of Southampton, UK
*
Reprint requests to Farooq Naeem, Department of Psychiatry, University of Southampton, Southampton SO14 3ED, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

CognitivetherapyculturePakistanadaptationtrial
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 39 , Issue 2 , March 2011 , pp. 165 - 173
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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 8Google Scholar
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), 995–1000.CrossRefGoogle Scholar
Barrera, M. and Castro, F. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology Science Practice, 13, 311–316.CrossRefGoogle Scholar
Hall, G. (2001). Psychotherapy research with ethnic minorities: empirical, ethical, and conceptual issues. Journal of Consulting and Clinical Psychology, 69, 502–510.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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), 1191–1194.CrossRefGoogle Scholar
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, 81–85.CrossRefGoogle ScholarPubMed
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, 379–86CrossRefGoogle ScholarPubMed
Naeem, F. (2005). Five months back in Pakistan: clinical reflections. Psychiatric Times, November, 43–44.Google Scholar
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.CrossRefGoogle Scholar
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)?Google Scholar
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, 847–855.CrossRefGoogle Scholar
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, 79–84.Google Scholar
National Institute for Health and Clinical Excellence (2004). Depression: management of depression in primary and secondary care. NICE clinical guideline 23. London: NICE.Google Scholar
Padesky, C. and Greenberger, D. (1995). Clinicians Guide to Mind over Mood. New York: The Guilford Press.Google Scholar
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), 902–909.CrossRefGoogle Scholar
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, 234–245.CrossRefGoogle ScholarPubMed
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, 51–59.CrossRefGoogle Scholar
Wen-Shing, Tseng (2004). Culture and psychotherapy: Asian perspectives. Journal of Mental Health, 13, 151–161.Google Scholar
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, 142–148.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.