Comparison of the effectiveness of group interventions on Indian women diagnosed with mild to moderate depression at an urban psychiatric clinic in KwaZulu–Natal

Abstract

The aim of this quasi-experimental study was to compare the effectiveness of a Nurse-facilitated cognitive group intervention, a Volunteer-led support group intervention and a standard treatment Control group on mild to moderately depressed Indian women at an urban community psychiatric clinic in KwaZulu-Natal in terms of their levels of depression and self-esteem over a three-month period. Since antidepressants alone are ineffective in the treatment of depression, the study evaluated group interventions as adjunctive treatments. The first intervention involved 15 group sessions based on Gordon’s teachings (1988a and 1988b), whilst the second intervention consisted of 15 craft-making group sessions. A purposive sample of 45 depressed women was selected and randomly allocated to the three groups. Sample selection criteria included a Beck Depression Inventory score between 9 and 29, being aged between 25 and 65 years and using antidepressant medication. For ethical reasons, all participants continued with their “standard” antidepressant treatment throughout the study. The Personal Profile Questionnaire (PPQ), the Beck Depression Inventory Scale (BDI) 1978, the Rosenberg Self-Esteem Scale (RSE) 1965, the Life-Experience Survey (LES) 1977 questionnaire and a question on exercise were used to assess the effectiveness of the group interventions. Pre-test (prior to the introduction of the intervention) and two sequential Post-test scoring (after 6 and 12 weeks of interventions) were undertaken using the above-named instruments. The Kruskal Willis and Friedman’s test were used to detect changes in levels of depression and self-esteem between and within the three groups respectively, at the p = 0.05 levels of significance. The intergroup comparison showed statistically significant improvements in the BDI score of Experimental groups 1 and 2, with p = 0.00. There were no changes in the Control group. The intra-group comparison showed statistical significant improvements during the study within the intervention groups (p = 0.00 in both cases) but not in the Control group. No statistically significant change in the RSE amongst or within the three group was detected. The study has shown that group interventions as an adjunct to antidepressant treatment are beneficial as rehabilitation programmes for depressed women. Furthermore, volunteers and psychiatric nurses with training in using group interventions may be useful in assisting depressed patients to enhance their quality of life.