A randomised controlled trial on the effect of a cognitive behavioural bibliotherapy self-help intervention program on increasing resilience in individuals with depression.
- Conditions
- Resilience levels of participants with depressionDepression levels of participants with depressionPsychological distress levels of participants with depressionMental Health - Depression
- Registration Number
- ACTRN12611000905965
- Lead Sponsor
- Victoria University
- Brief Summary
Aim The aims of the study were to evaluate if individuals diagnosed with moderate depression who took part in a cognitive behavioural bibliotherapy self-help intervention programme, as well as continuing to receive standard care, would have greater resilience and lower levels of depression and psychological distress than those who receive only standard care. Background information The prevalence of depression in Thailand is increasing markedly, and depression is projected to become the major mental health problem in the country. One way to help in this situation is to use bibliotherapy. Most bibliotherapy studies of depression have taken place in developed countries, in particular, Australia, UK and the US; none have been undertaken in Thailand and other Asian countries. Method An RCT was used to evaluate the effectiveness of an 8-week modularised self-help intervention program in promoting resilience in people living in the community with moderate depression. Participants were recruited through the outpatients’ department at Suan Prung Psychiatric Hospital, Chiang Mai, Thailand. Data were collected using the Resilience Scale, Centre for Epidemiologic Studies Depression Scale, and Kessler Psychological Distress Scale. Data were collected at baseline, at the end of intervention, and four weeks after the completion of the intervention. Participant characteristics The majority of participants were female (73%, n=41), and most were married or in de facto relationships (64.3%, n=36). Their average age was 42.13 years, ranging from 18 to 58 years. The duration of their illness was between 3 and 13 months for the intervention group and 5 and 18 months for the control group. Most (83.9%, n=47) were prescribed a combination of antidepressant (the majority were prescribed SSRIs) and anti-anxiety medications, while a small proportion (17.9%, n=10) received a combination of specialised psychological therapy and medications. Approximately 80% (n=44) of participants attended the psychiatric outpatients’ department at the hospital on a monthly or more frequent basis, while the remainder attended less frequently. Key results The findings showed there were statistically significant differences between the intervention and the control group in their resilience, depression and psychological distress levels. The participants who completed the self-help manual achieved greater resilience and lower levels of depression and psychological distress than the control group. Limitations First, recruitment through clinicians at the outpatients’ department might have resulted in an atypical sample of participants with depression. Second, the assessor of the outcome measures was not blinded to participant allocation to groups. In our opinion, while this did not have an adverse effect on the findings, it is, nonetheless, a potential limitation. Third, generalisabilty of the findings is limited to individuals who have some reading and writing capability, and bibliotherapy may not be appropriate for everyone with moderate depression, especially those who lack energy and have poor concentration.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 56
(i) diagnosis of moderate depression, (ii) hospital outpatient, (ii) aged 18–60 years, (iv) can read and write Thai, (v) and contactable by telephone at home.
(i) history of developmental disability or psychosis, and (ii) before entry and during the study: reporting suicidal thoughts/intent.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method