Department of Nutrition, IMB, University of Oslo, Oslo, Norway.
Department of Haematology, Oslo University Hospital, Oslo, Norway.
BMC Psychiatry. 2024 Sep 11;24(1):610. doi: 10.1186/s12888-024-06056-9.
Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda.
We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies - Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections.
We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management.
The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023.
尽管人们对精神健康障碍的认识不断提高，治疗水平也有所提高，但这些障碍仍然是全球发病率的主要原因。值得注意的是，像乌干达这样的中低收入国家受到这些障碍的影响不成比例。在这些国家，学生的抑郁症状负担尤其高，贫困、营养不良和公共卫生治理不善使情况更加恶化，但由于研究不足，难以实现联合国可持续发展目标中的几个目标。目前的治疗选择不足以应对日益增加的抑郁疾病负担。对于资源匮乏的地区，特别是撒哈拉以南非洲地区，情况更为严峻，这表明需要寻找其他治疗方法，如果被证明有效，这些方法可以迅速应用。因此，这项随机对照试验（RCT）的主要目的是检验一种基于当地乌干达食物的低成本健康饮食与易于获得的正念认知疗法相结合是否可以减少乌干达大学生的抑郁症状。
我们将招募乌干达最大的公立大学 Makerere 大学的女性和男性学生参加一项开放、意向治疗、双臂 RCT。那些在自我报告的抑郁症状评估中得分高于预定阈值的人（用中心流行病学研究-抑郁量表 (CES-D) 测量）有资格参加研究，他们将被随机分配到干预组（n=125）或对照组（n=125）。干预组将接受关于如何准备地中海式健康饮食和如何坚持正念认知疗法原则的教育小组课程。结果测量包括自我报告的抑郁症状、生活质量和饮食摄入量。此外，我们将进行成本效益分析。RCT 干预将持续 9 个月，之后将进行额外的 15 个月的定期数据收集。
我们在这里描述了一种治疗生活在资源有限环境中的大学生抑郁症状的新方法，即通过将健康饮食与低门槛心理治疗相结合。如果这种干预措施成功，我们的项目可以被视为为患有常见精神障碍（抑郁症）的年轻人提供基于证据的行为实践的一步，这对公共精神健康计划和管理有益。
该 RCT 在 ClinicalTrials.gov 注册（ID：NCT05848973）。注册日期为 2023 年 8 月 14 日。
