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Table 2 Narrative summary of reviewed studies

From: Psychological and social interventions for mental health issues and disorders in Southeast Asia: a systematic review

Paper title (with unique ID) Outcome(s) targeted Intervention type Number of participants Individual or Group delivery Duration Effectiveness (results)
The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. (Patel et al. 2017)  [49] Depression Severity
Remission From Depression
Suicidal Thoughts
HAP is a brief psychological treatment adapted from behavioural activation including: psychoeducation, behavioural assessment, activity monitoring, activity structuring and scheduling, activation of social networks, and problem solving N = 493 Individual – at home or over the telephone 6–8 week period for 30–40 min per session Intervention group (IG) experienced reduced depressive symptom severity (P < 0.001), higher remission in depression (P < 0.001) and reduced suicidal thoughts or attempts (P < 0.0001) versus the control group (CG) after 3 months
Effectiveness of the Thinking Healthy Programme (THP) for perinatal depression delivered through peers: Pooled analysis of two randomized controlled trials in India and Pakistan. (Vanobberghen et al. 2020)  [71] Depression severity
Remission from depression
THP is based on: behavioural activation, active listening, collaboration with the patient’s family, guided discovery and homework N = 850 Both 6–14 weeks over the 6 month prenatal period to six months post-childbirth Compared to CG the IG was effective at reducing levels of depression (P = 0.03) and remission from depression (P = 0.04) at 6 months
Delivering the Thinking Healthy Programme for perinatal depression through peers: an individually randomised controlled trial in India. (Fuhr et al. 2019)  [41] Depression severity
Remission from depression
THP N = 280 Both 6–14 weeks over the 6 month prenatal period to six months post-childbirth IG reported reduced depression symptom severity at 3 months (P = 0.01), disability (P = 0.009) relative to the CG. The IG also reported improved recovery (P = 0.03). No evidence of an intervention effect on remission at 3 months (P = 0.08) or WHO-DAS score at 6 months (P = 0.16)
Internet-based behavioural activation with lay counsellor support versus online minimal psychoeducation without support for treatment of depression: a randomised controlled trial in Indonesia (Arjadi et al. 2018)  [68] Depression
Fear and avoidance
Social Support
Quality of Life
Online behavioural activation N = 313 Individual Eight weekly structured modules, with assignments, that could be completed in 30–45 min each IG delivered by lay counsellors with peer support was led to significantly lower depression scores versus CG (P = 0.017). These results were maintained at 3 and 6 months
Effectiveness of psychological treatments for depression and alcohol use disorder delivered by community-based counsellors: two pragmatic randomised controlled trials within primary healthcare in Nepal (Jordans et al. 2019)  [64] Depression
Substance Use Disorder
HAP N = 120 Individual – at home or over the telephone 6–8 week period for 30–40 min per session IG vrs CG reported significantly lower depressive symptom severity (P < 0.001) at 3 and 12 month follow up (P < 0.001) amongst depressed patients in primary care
Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. (Patel et al. 2010)  [56] Common Mental Health Disorders
Disability
Suicidal Thoughts
MANAS is a collaborative stepped-care intervention which includes case management along with psychoeducation and individual counselling (a minimum of 6 sessions with maximum of 12 sessions) provided by a trained lay health counsellor, which were supplemented by antidepressant medication dispensed by a primary care physician and supervised by a mental health specialist N = 2796 Individual level within clusters Over a 6 month period This study conducted a subgroup analysis on participants with depression and no significant difference was found between the IG and CG (P = 0.07)
Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months. (Patel et al. 2011) [40] Common Mental Health Disorders
Disability
Suicidal Thoughts
MANAS N = 2796 Individual level within clusters Over a 6 month period The overall effect was a 30% reduction in prevalence in the ICD-10 diagnosis group between arms (P = 0.02); 24% reduction in the depression subgroup (P = 0.04); 34% reduction in the screen-positive group (P = 0.03); and 57% reduction in the sub-threshold subgroup (P = 0.11). Results not sustained at 6/12 months
5-HTTLPR and MTHFR 677C > T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial. (Tolahunase, 2018a) [51] Major Depressive Disorder  Yoga and meditation lifestyle intervention (YMLI): incorporating physical yoga poses, breathing exercises and meditation N = 178 Mix of both Each session lasting for 2 h, practiced 5 days a week over 12 weeks. The first 2 weeks of the intervention included supervised group sessions, which included lectures on yoga, meditation, major depressive disorder (MDD) and the importance of depressive symptom prevention and management. The remaining 10 weeks was completed individually at home, including one to one and unsupervised sessions The IG had a significant effect on depression severity versus CG (P < 0.001). A stratified analysis found that this change was significant for the deemed to have moderate (P = 0.029) and severe MDD (P < 0.01) at baseline but not mild MDD (P < 0.072) after YMLI compared to CG. Clinical improvement was more significant for the women in IG (P = 0.032)
Yoga- And Meditation-Based Lifestyle Intervention Increases Neuroplasticity and Reduces Severity of Major Depressive Disorder: A Randomized Controlled Trial. (Tolahunase et al. 2018b)  [42] Major Depressive Disorder YMLI N = 58 Mix of both Each session lasting for 2 hours, practiced 5 days a week over 12 weeks. The first 2 weeks of the intervention included supervised group sessions, which included lectures on yoga, meditation, major depressive disorder and the importance of depressive symptom prevention and management. The remaining 10 weeks was completed individually at home, including one to one and unsupervised sessions For the IG there was a significant decrease difference between means in BDI-II (depression) score (P < 0.001) and significant increase in BDNF (Brain-derived neurotrophic factor) (P < 0.001) post 12- weeks compared to the CG
Comparative Effectiveness of Mindfulness-Based Therapy
in Sleep Quality of Chronic Insomnia Compared to
Standard Cognitive Behavioral Therapy [CBT-I]:
A Randomized Controlled Trial. (Siritienthong et al. 2018)  [58]
Sleep Quality
Depression
Anxiety
Mindfulness level
Mindfulness Based Therapy N = 25 Group Weekly session for 8 weeks lasting 1.5–2 h There were no differences between the IG and the CG on sleep quality (P = 0.76), depression symptoms (P = 0.49), anxiety symptoms (P = 0.14) and mindfulness levels (P = 0.25)
Effectiveness of integrated body-mind-spirit group intervention on the well-being of Indian patients with depression: a pilot study (Rentala et al. 2013)  [43] Depression
Well-being
Work and social adjustment
Integrated body-mind-spirit group intervention (IBMSGI): intervention includes lectures on emotional and health management, stress reduction training (including breathing and meditative techniques), acupressure exercises, and homework activities such as writing and drawing, which encourage participant to focus on positive meanings within negative experience N = 30 Group Weekly session for 4 weeks lasting for 3 h Compared with the CG group, the
IG group showed statistically significant decreases in depression (P < 0.001) and functional impairment (P < 0.001)
and statistically significant increases in the well-being (P < 0.001) over the 6-month interval
Effectiveness of body-mind-spirit intervention on well-being, functional impairment and quality of life among depressive patients—a randomized controlled trial (Rentala et al. 2015) [50] Depression
Well-being
Functional impairment
Quality of life
IBMSGI N = 120 Group Weekly session for 4 weeks lasting for 3 h Compared with the CG group, the IG group showed statistically significant decreases in depression and functional impairment P < 0.001 and statistically significant increases in the well-being and quality of life P < 0.001 over the 6-month interval
Impact of Yoga Nidra on psychological general well-being in patients with menstrual irregularities: A randomized controlled trials (Rani et al. 2011)  [44] Well-being
Anxiety
Depression
Yoga Nidra deep relaxation therapy N = 150 Group 35 min a day, 5 days a week for six months After six months those in the IG compared with the CG had significant reduction in Anxiety (t-test, P value) 3.00 0.003 Depression 2.57 0.01 and Positive well-being 2.26 0.02
Yoga Nidra as a complementary treatment of anxiety and depressive symptoms in patients with menstrual disorder. (Rani et al. 2012)  [52] Severity of anxiety and depressive symptoms Yoga Nidra N = 150 Group 35 min a day, 5 days a week for six months Compared to the CG the IG improved mild to moderate depression symptoms of women with menstrual disorder (P < 0.02) after 6 months but not severe depressive symptoms. Overall significant improvement in anxiety (P < 0.003) and depression (P < 0.02) in IG in comparison to CG
Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial. (Rani et al. 2016) [45] Anxiety
Depression
Positive well-being
Self-control
General health
Vitality
Yoga Nidra N = 87 Group 35 min a day, 5 days a week for six months IG improved depressive symptoms of women with menstrual disorder (P < 0.02) after 6 months compared to CG. Significant improvement in domains of anxiety (P < 0.01), depression (P < 0.02), positive well-being (P < 0.01), general health (P < 0.04) and vitality (P < 0.02) in IG was noted after six months of yogic intervention when compared to CG
The impact of an add-on video assisted structured aerobic exercise module on mood and somatic symptoms among women with depressive disorders: study from a tertiary care centre in India (Roy, 2018)  [46] Reduction in depression Video Assisted Structured
Aerobic Exercise Program
N = 40 Group Consists of 20 min of moderate to low intensity aerobic exercises, delivered in a group format via a laptop, supervised by a registered nurse, every day for 10 days IG versus CG improved levels of depression (P < 0.05) at the programme’s end but not mood score or somatic symptoms related to depression
Cognitive-behavioural therapy for depression among menopausal women: A randomized controlled trial. (Reddy et al. 2019)  [47] Depression Cognitive Behavioural Therapy (CBT) N = 102 Group Weekly sessions for 6 weeks Compared with the CG, the IG group showed statistically significant decrease in depression scores (P = 0.000) over the 6-month period
A randomized controlled effectiveness trial of cognitive behaviour therapy for post-traumatic stress disorder in terrorist-affected people in Thailand (Bryant et al. 2011)  [59] Reduction in PTSD symptoms CBT N = 28 Individual Weekly sessions for 8 weeks Compared with CG the IG reported significantly improved PTSD (P = 0.001), depressive symptoms (P = 0.004) and complex grief post treatment symptoms (P = 0.001) post intervention and 3 months (P = 0.007 for PTSD; P = 0.003 for depression and P = 0.003 for complicated grief) post treatment
Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial. (Songprakun & McCann, 2012a) [61] Depression Psychological Distress Bibliotherapy: self-help and CBT based manual N = 56 Individual Weekly for 8 weeks IG versus CG improved depression post treatment (P = 0.018) and 4 weeks (depression P = 0.005) but no change in psychological distress
Effectiveness of a self-help manual on the promotion of resilience in individuals with depression in Thailand: a randomised controlled trial. (Songprakun & McCann, 2012b)  [62] Resilience Depression Bibliotherapy N = 56 Individual Weekly for 8 weeks IG versus CG improved resilience levels (P = 0.029), and depression post treatment (P = 0.018) and 4 weeks hence (resilience P = 0.004; depression P = 0.005)
Evaluation of a cognitive behavioural self-help manual
for reducing depression: a randomized controlled trial (Songprakun & McCann, 2012c)  [63]
Depression Bibliotherapy N = 56 Individual Weekly for 8 weeks IG group showed a significant decrease in depression scores from baseline to post-test (P = 0.018) and from baseline to follow-up (P = 0.005), but no significant decrease from post-test to follow-up (P = 1.00)
Effectiveness of community-based depression intervention programme (ComDIP) to manage women with depression in primary care- randomised control trial. (Indu et al. 2018)  [53] Depression
Quality of Life
Community-based depression intervention programme (ComDIP): includes psychoeducation, behavioural activation, relation between negative thoughts and behaviour discussion and drug treatment N = 60 Individual Weekly for 8 weeks In the IG there was a large effect on depressive severity with women with depression (P = 0.01) and quality of life (P = 0.006) was found at 8 weeks versus CG
Effectiveness of non-medical health worker-led counselling on psychological distress: a randomized controlled trial in rural Nepal. (Markkula et al. 2019)  [65] Depression
Anxiety
Counselling intervention: emotional support along with problem solving and coping skills development N = 287 Individual Five 45 min appointments, two of which were completed in the first week, with meetings being weekly from weeks two to four IG who received 6 months training, delivered in a primary care setting was effective versus CG at improving depressive and anxiety symptoms at 1 and 6 months (P-Values not reported)
Brief cognitive behavioral therapy for depression among patients with alcohol dependence in Thailand (Thapinta et al. 2014) [48] Depression Alcohol dependence CBT N = 80 Group 6 sessions delivered over 3 weeks IG delivered over a 3 week period was effective at reducing depression among Thai general hospital patients with alcohol dependence post intervention (P < .01) and 7 weeks later (P < .01)
Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial (Chatterjee et al. 2019) [55] Change in Schizophrenia symptoms and disabilities
Adherence to antipsychotic treatment and experience of stigma and discrimination
Community care for People with Schizophrenia: individualised treatment plan including clinical review, psychoeducation, medication adherence, health promotion strategies, self-help group referral and community agency engagement N = 282 Individual Delivered in different phases: intensive engagement (0-3 months), stabilization (4–7 months) and maintenance phases (8–12 months) For the IG in the intensive engagement (0-3 months), the stabilization (4–7 months), and the maintenance (8–12 months) vs CG reduced positive and negative symptoms of Schizophrenia and disabilities at 12 months (P = 0.01)
The effect of telephone support on depressive symptoms among HIV-infected pregnant women in Thailand: an embedded mixed methods study (Ross et al. 2013)  [60] Reduction in depressive symptoms Individual telephone counselling: focussing on emotional and informational support N = 40 Individual Weekly for 15 to 30 min Compared to CG the IG reduced depressive symptoms after 1 (p = .044) and 2 months (p = .001) of receiving this intervention
Efficacy and cost-effectiveness of drug and psychological treatments for common mental disorders in general health care in Goa, India: a randomised, controlled trial (Patel et al. 2003) [54] Psychiatric morbidity A) Antidepressant or Psychological Intervention: key features of which were: 1) explanation of the treatment and
reassurance, 2) relaxation (breathing exercises), 3)
treatment for specific symptoms (dependent on the
patient’s report)—eg, activity scheduling for tiredness or
establishing sleep routines for sleep problems, and 4) problem solving; or Placebo
N = 450 Individual Psychological treatment: weekly intervals for the initial sessions,
and fortnightly thereafter for up to six sessions
IG had reduced psychiatric morbidity (measure by CISR total score) than with placebo at 2 months (P = 0.005) but not from 2 to 12 months (P = 0.1). CG was not more effective than placebo for any outcome at all the time points (P = 0.86 at 2 months and P = 0.48 at 2–12 months)
Resource activation for treating post-traumatic stress disorder, co-morbid symptoms and impaired functioning: a randomized controlled trial in Cambodia (Steinert et al. 2017) [66] Remission rates of PTSD
Symptoms of depression and anxiety
Self-perception of functioning (SPF)
Depression and emotional distress status
ROTATE: Resource-oriented trauma therapy combined with eye movement desensitization and reprocessing (EMDR) resource installation N = 86 Individual 5 h in total delivered on a weekly basis IG reported significantly reduced levels of depression, anxiety and impaired functioning and increased PTSD remission rates (P < 0.001) compared with CG
The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste. (Schubert et al. 2016) [69] Severity of PTSD, Depression and Anxiety symptoms: Psychophysiological response EMDR therapy N = 21 Individual Up to 10 sessions lasting 60 – 90 min IG versus CG control was significant in reducing depression, anxiety and PTSD post intervention (P < 0.001), and depression three months later (P = 0.034). There were no significant differences in anxiety or PTSD symptoms 3 months later
Unanticipated effect of a randomized peer network intervention on depressive symptoms among young methamphetamine users in Thailand (German et al. 2012)  [57] Sexual risk behaviour
Methamphetamine use
Depression
Peer-educator network-oriented intervention N = 983 Group Delivered twice weekly, was 7 sessions in duration, with each session lasting 2 h, over the course of a month Post-assessment the IG group showed a significantly different decreasing trend in depressive symptoms as indicated by the condition-by-time interaction (P < 0.0001)
Symptoms scores of PTSD and anxiety were remained the same at 3-month follow-up, but depression scores continued to decrease
Effect of mobile phone-based psychotherapy in suicide prevention: a randomized controlled trial in Sri Lanka (Marasinghe et al. 2012)  [70] Suicidal ideation
Depression
Brief Mobile Treatment N = 68 Phase 1: Group Phase 2: Individual Phase 1: training in problem solving, meditation, increasing social support skills, as well as advice on alcohol and drug use
Phase 2: followed up by 10 phone calls over 24 weeks, along with weekly SMS reminders and 5 min audio voice messages to reinforce the learning from this training
IG reported reduced suicidal ideation and depression in people who recently attempted suicide versus CG at 6 and 12 months (No P-Values reported)
Testimony Therapy With Ritual: a Pilot Randomized Controlled Trial (Esala & Taing, 2017)  [67] Severity of PTSD, anxiety, and depression Testimony Therapy plus ceremony (culturally adapted ceremony which involves a Buddhist ceremony and a truth-telling event) N = 120 Both Included 4 days of individual counselling and a culturally adapted group ceremony on the 5th and final day Compared to the CG the IG reported significant reduction in depression symptoms p = .001, but symptoms did not significantly decrease from 3 to 6 months. Again, there was a significant reduction in anxiety symptoms for IG from baseline to 3 months, p = .001, but symptoms did not significantly decrease from 3 to 6 months