TY - JOUR
T1 - Effectiveness of counseling for anxiety and depression in mothers of children ages 0-30 months by community workers in Karachi, Pakistan
T2 - A quasi experimental study
AU - Ali, Niloufer S.
AU - Ali, Badar S.
AU - Azam, Iqbal S.
AU - Khuwaja, Ali K.
N1 - Funding Information:
We are indebted to The Aga Khan University Research Council, which provided a grant for conducting this study. We are also grateful to the administration of Sir Syed hospital for providing space for training community based workers and Ghaffoor Memorial Welfare Trust for providing us with a field office during the study period. We would like to acknowledge the efforts of our community based workers, field supervisor Ms Asia and clinical psychologist Ms Ghurnata Tabassum in conducting the study. We would also like to acknowledge Dr Graeme Cane, Head, Centre of English Language, Institute for Educational Development, The Aga Khan University for copyediting the manuscript as native English speaking colleague. Last but not least, we wish to acknowledge the cooperation of the people of Qayoomabad and Manzoor Colony without whose participation, this study would not have been possible. Funding: The project was funded by The Aga Khan University Research Council (Grant number: 022006 CHS).
PY - 2010/7/19
Y1 - 2010/7/19
N2 - Background: The prevalence of anxiety/depression is quite high during the perinatal period but unfortunately its detection and treatment have been less than satisfactory. Moreover, many women are reluctant to take pharmacotherapy for fear of excretion of drugs into their breast milk. This study assesses the effectiveness of counseling from minimally trained community health workers in reducing anxiety/depression, the rate of recurrence and the interval preceding recurrence in women during first two and a half years after childbirth.Methods: In a quasi-experimental study, community women from two under-privileged communities were trained in data gathering, teaching healthy child-rearing practices, basic counseling skills, and screening for anxiety/depression by using an indigenously developed questionnaire, the Aga Khan University Anxiety and Depression Scale (AKUADS). The diagnosis was further confirmed by a clinical psychologist using DSM IV criteria. After obtaining consent, 420 women were screened and 102 were identified as having anxiety/depression. Screening was carried out after 1, 2, 6, 12, 18, 24 and 30 months of a live birth. Only 62 out of 102 agreed to be counseled and received eight weekly sessions. AKUADS was re-administered at 4 weeks and 8 weeks after the beginning of counseling; this was followed by the clinical psychologist's interview for confirmation of response. After recovery, screening was continued every 3 months for detection of recurrence throughout the study period. Out of the women who had declined counseling 12 agreed to retake AKUADS after 4 and 8 weeks of diagnosis. Independent samples t-test, chi-square test, Repeated Measures ANOVA and Kaplan Meier technique were used for the analysis.Results: A significant decline in level of anxiety/depression was found in both the counseled and the non-counseled groups at 4 and 8 weeks (p-value < 0.001) but the counseled group fared better than the non-counseled for recovery, reduction in the rate of recurrence and increase in the duration before relapse.Conclusions: As our results cannot be generalized; further studies need to be carried out, to assess the benefit of incorporating minimal counseling skills in the training of community health workers.
AB - Background: The prevalence of anxiety/depression is quite high during the perinatal period but unfortunately its detection and treatment have been less than satisfactory. Moreover, many women are reluctant to take pharmacotherapy for fear of excretion of drugs into their breast milk. This study assesses the effectiveness of counseling from minimally trained community health workers in reducing anxiety/depression, the rate of recurrence and the interval preceding recurrence in women during first two and a half years after childbirth.Methods: In a quasi-experimental study, community women from two under-privileged communities were trained in data gathering, teaching healthy child-rearing practices, basic counseling skills, and screening for anxiety/depression by using an indigenously developed questionnaire, the Aga Khan University Anxiety and Depression Scale (AKUADS). The diagnosis was further confirmed by a clinical psychologist using DSM IV criteria. After obtaining consent, 420 women were screened and 102 were identified as having anxiety/depression. Screening was carried out after 1, 2, 6, 12, 18, 24 and 30 months of a live birth. Only 62 out of 102 agreed to be counseled and received eight weekly sessions. AKUADS was re-administered at 4 weeks and 8 weeks after the beginning of counseling; this was followed by the clinical psychologist's interview for confirmation of response. After recovery, screening was continued every 3 months for detection of recurrence throughout the study period. Out of the women who had declined counseling 12 agreed to retake AKUADS after 4 and 8 weeks of diagnosis. Independent samples t-test, chi-square test, Repeated Measures ANOVA and Kaplan Meier technique were used for the analysis.Results: A significant decline in level of anxiety/depression was found in both the counseled and the non-counseled groups at 4 and 8 weeks (p-value < 0.001) but the counseled group fared better than the non-counseled for recovery, reduction in the rate of recurrence and increase in the duration before relapse.Conclusions: As our results cannot be generalized; further studies need to be carried out, to assess the benefit of incorporating minimal counseling skills in the training of community health workers.
UR - http://www.scopus.com/inward/record.url?scp=77954674612&partnerID=8YFLogxK
U2 - 10.1186/1471-244X-10-57
DO - 10.1186/1471-244X-10-57
M3 - Article
C2 - 20642820
AN - SCOPUS:77954674612
SN - 1471-244X
VL - 10
JO - BMC Psychiatry
JF - BMC Psychiatry
M1 - 57
ER -