Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Feb 29:12:14.
doi: 10.1186/1471-244X-12-14.

Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif)

Sarah Ayoughi  1 , Inge Missmahl, Roland Weierstall, Thomas Elbert
Affiliations
Randomized Controlled Trial

Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif)

Sarah Ayoughi et al. BMC Psychiatry. .

Abstract

Background: Psychosocial stress caused by war, ongoing conflict, lack of security, and restricted access to resources promotes mental suffering and diseases in many resource-poor countries. In an exemplary setting, the present study compares the efficacy of psychosocial counselling with routine pharmacological treatment in a randomised trial in Mazar-e-Sharif (Afghanistan).

Methods: Help seeking Afghan women (N = 61), who were diagnosed with mental health symptoms by local physicians either received routine medical treatment(treatment as usual) or psychosocial counselling (5-8 sessions) following a specifically developed manualised treatment protocol. Primary outcome measures were symptoms of depression and anxiety assessed before treatment and at follow-up using the Hopkins Symptom Checklist and the Mini-International Neuropsychiatric Interview. Secondary outcome measures were psychosocial stressors and coping mechanisms.

Results: At 3-month follow-up, psychosocial counselling patients showed high improvements with respect to the severity of symptoms of depression and anxiety. In addition, they reported a reduction of psychosocial stressors and showed an enhancement of coping strategies. At the same time, the severity of symptoms, the quantity of psychosocial stressors and coping mechanisms did not improve in patients receiving routine medical treatment.

Conclusion: These results indicate that psychosocial counselling can be an effective treatment for mental illnesses even for those living in ongoing unsafe environments.

Trial registration: ClinicalTrials.gov NCT01155687.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of the study protocol.
Figure 2
Figure 2
Change in HSCL-Depression/-Anxiety scores. a. Change in HSCL-Depression scores. b. Change in HSCL-Anxiety scores.
Figure 3
Figure 3
Psychosocial stressors.
Figure 4
Figure 4
The effect of psychosocial stressors on the treatment outcome regarding depression and anxiety. a. The effect of psychosocial stressors on the treatment outcome regarding depression. b. The effect of psychosocial stressors on the treatment outcome regarding anxiety.
See this image and copyright information in PMC

References

    1. Lopez Cardozo B, Bilukh O, Gotway Crawford C, Shaikh I, Wolfe M, Gerber M. et al.Mental health, social functioning, and disability in postwar Afghanistan. J Am Med Assoc. 2004;292:575–584. doi: 10.1001/jama.292.5.575. - DOI - PubMed
    1. Lopez Cardozo B, Bilukh O, Gotway Crawford C, Shaikh I, Wolfe M, Gerber M. et al.Mental health of women in postwar Afghanistan. J Womens Health. 2005;14(4):285–293. doi: 10.1089/jwh.2005.14.285. - DOI - PubMed
    1. Rasekh Z, Bauer HM, Manos MM, Iacopino V. Women's health and human rights in Afghanistan. J Am Med Assoc. 1998;280:449–455. doi: 10.1001/jama.280.5.449. - DOI - PubMed
    1. Scholte W, Olff M, Ventevogel P, de Vries GJ, Jansveld E, Lopes Cardozo B. et al.Mental health symptoms following war and repression in eastern Afghanistan. J Am Med Assoc. 2004;292:585–593. doi: 10.1001/jama.292.5.585. - DOI - PubMed
    1. Miller KE, Omidian P, Rasmussen A, Daudzai H, Yaqubi A. Daily stressors, war experiences, and mental health in Afghanistan. Transcult Psychiatry. 2008;45(4):611–638. doi: 10.1177/1363461508100785. - DOI - PubMed

Publication types

Associated data