LOGOTHERAPY AND COGNITIVE BEHAVIOURAL THERAPY IN THE TREATMENT OF DEPRESSIVE DISORDER AMONG STIGMATISED PEOPLE LIVING WITH HIV/AIDS IN OYO STATE, NIGERIA

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.