Evaluating the Outcome of Cultural Adaptations of Cognitive-Behavioural Therapy for Adult Depression: a Meta-Analysis of Treatment Studies in Developing Countries

摘要

Cognitive-behavioural therapy (CBT) is promoted as a treatment of choice for adult depression in the developed world. In low- and middle-income countries (LAMICS), the standard treatment protocol is often adapted to meet the socio-cultural needs of the context. The authors conducted a systematic review of all controlled studies of culturally-adapted CBT involving adults with depression resident in LAMICS. The pooled mean effect size from 11 studies (n = 1602) was large, suggesting that CBT appears efficacious in treating depression in impoverished contexts. Specifically, treatments implemented with individuals were more successful than those administered to groups. Interventions employed by lay workers proved similarly successful. These results are encouraging, as the widespread adoption of CBT may potentially contribute to reducing the treatment gap for depression in resource-poor LAMICS.