Effect of Behavioural Therapy on Depression in Adolescents with Sickle Cell Disease

Abstract

Background: Depression, one of the commonest mental health problems in SCD, has high prevalence rates. While psychological therapies have been found to be beneficial in mild to moderate depression, their use as non-pharmacological methods amongst adolescents in sub-Saharan Africa, particularly Nigeria, is still at its infancy. Objective: To determine the effect of behavioural activation therapy on depression in adolescents living with Sickle Cell Disease attending out-patient clinic at the Lagos State University Teaching Hospital, Lagos, Nigeria. Method: The study was conducted in Lagos State University Teaching Hospital, Lagos, Nigeria, between November 2017 to February 2018 (4 months) among adolescents living with SCD and depression attending out-patient clinic. A randomized control trial (RCT) was conducted among participants assigned to treatment (30) versus control (30) group. A manualized behavioral therapy programme developed was delivered to the treatment group. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 23. Pair T-test was used to compare the two groups across continuous variables, pre- and post intervention. Analysis of Covariance (ANCOVA) was used to determine treatment effects controlling for baseline scores. Result: After the intervention, the mean depression score reduced from 22.13 ± 3.08 to 13.02 ± 4.56 while Paediatric quality of life score increase from 62.57 ± 17.85 to 67.90 ± 7.99 in the treatment group (BDI, p < 0.001; PedsQL, p = 0.045). However, the pre- and post-intervention mean depression scores in the control group showed insignificant reduction from 22.23 ± 3.24 to 21.60 ± 2.75 and mean PedsQL from pre-intervention scores of 59.67 ± 12.60 to 56.73 ± 8.94 post intervention (BDI, p = 0.388; PedsQL, p = 0.242). From multivariate analysis (ANCOVA), only the Quality of Life scores ceased to show any significant effect of the intervention. Conclusion: This study further strengthens and supports the extant literature that behavioral therapy alone is efficacious for depressive.