EFFECT OF COGNITIVE BEHAVIOUR THERAPY–INFORMED PSYCHOEDUCATION ON DEPRESSIVE SYMPTOMS, TREATMENT ADHERENCE AND HOPE AMONG DEPRESSED ADOLESCENTS ATTENDING FEDERAL NEUROPSYCHIATRIC HOSPITAL, BENIN-CITY

Abstract

Introduction Depression is an affective disorder and the core symptoms are low mood, reduced energy and loss of interest in previously enjoyable activities. It affects between 2 and 15% of the general population and 5 to 20% of adolescents, globally. Depression often begins in adolescence and runs a chronic course into adulthood with a resultant impairment in functioning, ranging from impairment in social role to impairment in work, home and relationships. There is the paucity of information on the effects of psychological intervention for adolescents with clinical depression in the developing world. This study investigates the effects of a psychological intervention that includes elements of Cognitive Behavioural Therapy and psycho-education on depressive symptoms, knowledge about depression, attitudes towards treatment adherence and hope among depressed adolescents. Methodology The study was a pre and post design without a control group, involving 18 adolescents with clinically diagnosed depressive disorder, recruited from the hospitals’ medical records, who have been on antidepressants for 3 months or longer. Levels of depressive symptoms were determined at baseline and repeated at One week and Four weeks post-intervention using the Beck Depression Inventory (BDI) and the Short Mood and Feelings (SMF) Questionnaire. Children’s Hope Questionnaire, Knowledge of depression questionnaire and attitudes towards treatment adherence questionnaire were also administered at baseline and repeated at One and Four weeks post intervention. The data was cleaned and entered into SPSS version 20. Categorical variables were presented as proportions, while continuous variables were summarised using frequency tables or Means and Standard Deviations. The treatment effect was analyzed by comparing the differences in the mean of outcomes at baseline and post-intervention, using paired t-tests. The level of significance was 0.05%. Pearson correlation coefficient was used to explore associations between the continuous outcome measures. Results The BDI and SMF scores at baseline reduced significantly (p = 0.001) from 24.4 (SD 11.8) and 13.3 (SD 4.30) to 3.94 (SD 2.10) and 2.83 (SD 1.39) respectively at One-week post-intervention. There was also a statistically significant increase (p = 0.001) in the mean scores on the knowledge of depression, the Children’s Hope and the attitude towards treatment adherence at baseline compared with scores at One-week post-intervention. The differences in mean scores of all the outcome measures were sustained at Four weeks post-intervention. The participant's perception of the conduct of the intervention was high. Conclusion This study suggests that adding psycho-education with elements of Cognitive behaviour therapy to medical treatment of depressed adolescents produces further benefits to their mental health.