2003, Number 3
Seguimiento a dos años de una intervención psicoeducativa para mujeres con síntomas de depresión, en servicios de salud para población abierta.
Lara MA, Navarro C, Navarrete L, Liliana Mondragón, Rubí NA
Full text
Language: Spanish
References: 26
Page: 27-36
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ABSTRACT
Depression is recognized worldwide as one of the main problems of mental health, and the Mexican Department of Health’s Programme for Mental Health Action recognizes it as a key problem. This disorder occurs twice as often in women as it does in men, hence the need to seek treatment alternatives for this population as there is a lack of methodologically proven interventions that could be applied as part of public mental health programmes. The purpose of the study was to evaluate the effectiveness of a psychoeducational intervention for women with depressive symptoms, after two years, in comparison to a four month follow-up, to found out whether: 1) there was a continued reduction of depression symptoms (CES-D) and an improvement in self-esteem (Coopersmith); 2) there were differences between the interventions -group and individual-; 3) the participants continued to feel that the intervention had had an influence on their lives and their problems and, 4) participants felt that the intervention should continue to be implemented in the same way or should be modified.The study was carried out on a sub-sample of 39 women randomly selected from a total of 135 who had participated in the intervention and were evaluated after four months. The study was designed to compare a group condition (GC) with an Individual Minimum Condition (IMC), with pre- and post-treatment (15 days in the GC and one month in the IMC) and follow-up evaluations (4 month and 2 years in both of them). The GC consisted of six two-hour group sessions, organized around the educational material entitled Is it difficult to be a woman? A Guide to Depression, while the IMC consisted of an individual orientation session on the use of this educational material.
A Multiple Analysis of Variance (MANOVA) was carried out to evaluate the effectiveness of the model on depressive symptoms (CES-D). No significant differences were found between the GC and IMC, although differences were found over time. In this respect, subsequent analyses show that depression symptoms significantly increased between the four-month and two-year follow-up although the latter did not exceed pre-treatment evaluation levels. The MANOVA for self-esteem showed similar results: a lack of difference between the interventions yet differences within the groups. In this case, subsequent analyses showed a slight reduction in self-esteem at two years, although the latter continued to be significantly higher than at the pre-treatment stage. The evaluation of the intervention itself showed that a similar percentage to the latter (80%, 63%) continued to feel that the intervention had had a great influence on their lives and problems.
The reasons they gave for this were that they understood their problems and were able to cope with them better, their mood had improved, they had changed their way of thinking and knew themselves better and were more accepting of themselves. Ninety per cent felt that the intervention should continue to be implemented in the same way. Among the reasons they gave were: the freedom to express themselves (in GC & IMC), the group interaction (GC), the work of the facilitator (GC) and the orientator (IMC) and the fact that the guide helped them with their problems (IMC).
Although the study concludes that both interventions proved effective in reducing depressive symptoms in the short term and improving self-esteem in the short and long term and regarding the participants’ satisfaction, there are certain methodological limitations as to the lack of a control group, the rejection of the interview by some women and the size of the sub-sample, that are discussed.
REFERENCES
SPITZER RL, WILLIAMS JBW, GIBBON M: Guía del Usuario para La Entrevista Clínica Estructurada para el DSM-III-R (SCID). Departamento de Psiquiatría, Investigaciones Biomédicas de la Universidad de Columbia, Instituto Psiquiátrico del Estado de Nueva York. American Psychiatric Press, Inc. Washington, 1988.