Abstract
The Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation psychological treatment, was found to be effective in reducing depressive symptoms among primary care attendees in India. We now examine whether early response predicts depression (PHQ-9) outcomes at the primary endpoint of 3 months and sustained recovery at 12 months after enrollment and the extent to which this effect is influenced by sudden gains in the context of the larger randomized controlled trial. HAP participants (N = 245) who exhibited an early response (150 of 245 or 61.2%), as defined by a 50% reduction in depressive symptoms from baseline to Session 3, had lower depressive symptom scores than those who did not at 3 months (5.29 vs. 10.75, F = 33.21, p < .001) and at 12 months (6.56 vs. 11.02, F = 21.84, p < .001). Further exploratory analyses suggested that this advantage was largely confined to the subset of early responders who also showed sudden gains (87 of 150).
Highlights
Depression is the leading cause of disability among adults worldwide (Ferrari et al, 2013)
The current study explored the role of early response and sudden gains within a randomized controlled trial (RCT) evaluating the Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation (BA) treatment for patients with depression in primary care (Chowdhary et al, 2015)
We examined the frequency of early response and its predictive role on the severity of depression at the primary endpoint of 3 months and sustained depression outcomes at 12 months after enrollment
Summary
Depression is the leading cause of disability among adults worldwide (Ferrari et al, 2013). The current study explored the role of early response and sudden gains within a randomized controlled trial (RCT) evaluating the Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation (BA) treatment for patients with depression in primary care (Chowdhary et al, 2015). This trial was conducted in Goa, India. No study to our knowledge has examined the roles of early response or sudden gains within the context of a nonspecialistdelivered psychological treatment
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