Infectious Disease

Lay psychological interventions can improve depression and anxiety in adolescents

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Osborn and another author report support from the Templeton World Charity Foundation. Please refer to the study for all relevant financial information from the other authors.

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A lay psychological intervention that focused on positive human traits rather than psychopathology reduced depression and anxiety in adolescents, according to results from a randomized clinical trial in Kenya.

“This intervention, Shamiri (kiswahili for flourish), is designed to be implemented with young people who meet in groups led by trained laypeople.” Tom L. Osborn, AB, from Shamiri Institute and the Department of Psychology at Harvard University, and colleagues wrote in JAMA Psychiatry. “In a preliminary proof-of-concept study, Shamiri was tested with 51 Kenyan adolescents (aged 14 to 17 years) who showed increased symptoms of anxiety and / or depression. Adolescents who were randomly assigned to Shamiri (n = 28) showed a significantly greater reduction in depression and anxiety symptoms than adolescents who were randomly assigned to a study aptitude test (n = 23). ”

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However, according to Osborn and colleagues, the small sample size and limited follow-up weakened this study. In the current study, they wanted to determine whether Shamiri, a 4-week, lay-out intervention that includes elements of growth mentality, gratitude, and appreciation, improved depression and anxiety symptoms in symptomatic Kenyan adolescents aged 13-18. They included results that were assessed at baseline, post-treatment, and 2-week and 7-month follow-up from four secondary schools in two counties in Kenya, and used intent-to-treat analysis to determine the effects analyze.

Osborn and colleagues randomly assigned participants to the Shamiri intervention (n = 205) or a control group for learning skills (n = 208), and those in both conditions met in groups with an average size of 9 participants for 60 minutes each Week for 4 weeks. A total of 307 adolescents completed the 4-week intervention. Participants had a mean age of 15.5 years and 65.21% were female. The primary endpoints were symptoms of depression, which were assessed using the item Patient Health Questionnaire-8, and anxiety symptoms, which were assessed using the item Generalized Anxiety Disorder-7. The researchers hypothesized that analyzes of the assumed data show a significant reduction in symptoms of depression and anxiety in the Shamiri participants compared to those in the study-ability group.

The results showed that participants found both shamiri and study skills very useful, and that both reduced symptoms of depression and anxiety; however, analyzes with imputed data showed greater reductions in depressive symptoms at post-treatment, 2-week follow-up, and 7-month follow-up, and greater reductions in anxiety symptoms after treatment, 2-week follow-up in those who received Shamiri and 7 month follow-up.

“Shamiri was designed and implemented by a multicultural team with combined expertise in intervention science and the relevant cultural context – an approach that could be of value in global mental health research,” wrote Osborn and colleagues. “The positive results suggest the verifiable possibility that interventions that are simple in design, inexpensive, focus on positive human traits and strengths of character, and performed by laypeople, can make useful contributions to global mental health.”

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