Bolton 2007.
Methods | RCT | |
Participants | Acholi adolescents 14 to 17 years of age, living in 2 camps for internally displaced persons near Gulu, Uganda. The war in Northern Uganda represents one of the most violent and persistent complex humanitarian emergencies in the world. Over 1.8 million individuals, mainly ethnic Acholi, have been internally displaced during 20 years of conflict between the government of Uganda and the Lord's Resistance Army. Eligible participants scored greater than 32 on the depression symptom scale and greater than 0 on the function scale; had symptoms for at least 1 month; and resided in the camps during the preceding month. Exclusion criteria were inability to be interviewed due to a cognitive or physical disability and severe suicidal ideation or behaviour | |
Interventions | Group interpersonal psychotherapy (IPT‐G): 105 participants Wait list: 104 participants Creative play (CP): 105 participants |
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Outcomes | Depressive symptoms; anxiety symptoms; conduct problems; functioning. Recovery, defined as a reduction of 50% or more of an individual's baseline symptom severity score; remission, defined as at or less than a predefined cutoff score of 15.6 points (mean score of non‐cases in the validation study) | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "Random allocation was done by computerized generation of a random number between 1 and 400 for each eligible participant, ordering them by number and assigning the first third to IPT‐G, the second third to CP and the final third to the wait‐control group" |
Allocation concealment (selection bias) | Unclear risk | No information provided |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote: "Informed consent included advising each youth of the study group to which he or she had been allocated" |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: "Interviewers were blinded to interviewees’ intervention status" |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropouts reported at study endpoint (17/105 missing from creative play group; 9/105 missing from interpersonal psychotherapy group; 16/104 missing from control group) |
Selective reporting (reporting bias) | Low risk | All outcomes are correctly reported |
Therapist qualification | Unclear risk | Interventions were delivered by trained facilitators |
Treatment fidelity | Unclear risk | Quote: "IPT supervisors also provided weekly written reports that were reviewed and discussed with study staff during the phone meetings for adherence to the treatment model and to monitor human subject protection" |
Therapist/investigator allegiance | High risk | Manualised IPT was developed in the United States, and study authors were involved in training facilitators |
Other bias | Unclear risk | No information provided |