Abstract:
Depressive Disorder (DD) is a psychological maladjustment characterised by
persistently depressed mood or loss of interest in activities which causes significant
impairment in daily life. Impaired mental health like DD is commonly found among
stigmatised People Living With HIV/AIDS (PLWHA). Reports have revealed that
stigmatised PLWHA in Oyo State experience DD. Previous studies on the treatment of
DD among PLWHA concentrated more on pharmacological interventions than
psychotherapeutic interventions such as Logotherapy and Cognitive Behavioural
Therapy (CBT). This study, therefore, was designed to determine the effects of
Logotherapy and CBT on DD among stigmatised PLWHA in Oyo State, Nigeria. The
moderating effects of Socio-economic Status (SeS) and gender were also examined.
The study was anchored to the Cognitive Model, while the mixed methods design
(QUAN + Qual) was adopted. Three HIV facilities where PLWHA were receiving antiretroviral treatment in Oyo State were purposively selected. Fifty PLWHA receiving
treatment in each of the facilities were screened with Berger Stigmatisation (α=0.80) and
Hospital Anxiety and Depression (α=0.78) scales to identify those experiencing
stigmatisation and depressive symptoms. The participants who scored high against the
threshold of 8 and 40, respectively in the scales were selected and exposed to
Logotherapy (n=20), CBT (n=20) over eight weeks with a control (n=20) group. The
instruments used were SeS Scale (α=0.86) and Beck Depression Inventory (α=0.70).
Focused group discussions (FGD) were held in four sessions. Quantitative data were
analysed using descriptive statistics and Analysis of covariance at α0.05, while qualitative
data were content-analysed.
The participants’ age was 40.60 ± 2.57 years and 85% were female. There was a
significant main effect of treatments in the reduction of DD (F(2;42) = 31.55; partial ῆ2 =
0.60). The participants exposed to CBT had more reduced DD (𝑥̅=2.29) than those in
Logotherapy (𝑥̅=2.45) and control (𝑥̅=11.75) groups. There was a significant main effect
of SeS in reducing DD among study participants (F(2;42) = 31.55; partial ῆ2 = 0.22). The
participants with moderate SeS (3.93) in the CBT group had more reduced DD than their
counterparts with high (4.83) and low (8.59) SeS, respectively. There was significant
interaction effect of treatments and SeS in the reduction of DD among study participants
(F(2;42) = 3.64; partial ῆ2 = 0.257), in favour of participants with moderate (3.94) SeS in
the CBT group. There was no significant main effect of gender. Similarly, the interaction
effect of gender and treatment, the two-way interaction effects of gender and SeS, and
three-way interaction effects of treatment, gender and SeS were not significant. Fear of
living with the disease and daily drug intake are common themes associated with
depression. Excessive thinking, sadness, loss of weight, and inability to work are also
additional symptoms of depression.
Logotherapy and cognitive behavioural therapy effectively reduced depressive disorder
among stigmatised people living with HIV/AIDS in Oyo State, Nigeria, while cognitive
behavioural therapy was more effective. Clinical and counselling psychologists should
incorporate both therapies in the treatment of depressive disorder among stigmatised
people living with HIV/AIDS with consideration to socioeconomic status.