The goal of this clinical trial is to learn if group acceptance and commitment therapy works to improve depressive symptoms, psychological flexibility and quality of life in adults. The main questions it aims to answer are: 1. What is the effectiveness of group Acceptance and Commitment Therapy (ACT) in reducing depressive symptoms among depressive patients in Kelantan from pre- to post-intervention and at 3 months follow-up? 2. What is the mean difference of quality of life among depressive patients in Kelantan who undergo group ACT from pre- to post-intervention and at 3 months follow-up? 3. What is the effectiveness of group ACT in improving the psychological flexibility among depressive patients in Kelantan from pre- to post intervention and at 3 months follow-up? Researchers will compare group ACT group to a treatment-as-usual (TAU) group to see if group ACT works to improve depressive symptoms, quality of life and psychological flexibility. Participants will: * Attend weekly ACT sessions for four weeks or undergo standard treatment for major depressive disorder. * Fill up four questionnaires before the intervention, after a month and at 3-month follow-up.
General Objectives To study the effectiveness of group Acceptance and Commitment Therapy in the treatment of depression among depressive patients in Kelantan. Specific Objectives 1. To evaluate the effectiveness of group Acceptance and Commitment Therapy (ACT) in reducing the symptoms of depression in patients in Kelantan from pre- to post-intervention and at 3 months follow-up. 2. To determine the effectiveness of group Acceptance and Commitment Therapy (ACT) in improving the quality of life of patients with depression in Kelantan from pre- to post-intervention and at 3 months follow-up. 3. To assess the effectiveness of group Acceptance and Commitment Therapy (ACT) in improving the psychological flexibility of patients with depression in Kelantan from pre- to post intervention and at 3 months follow-up. This quasi-experimental study used a two-group design, comparing group ACT with TAU at baseline, post-intervention, and a 3-month follow-up. Conducted at the Psychiatry Clinic, Hospital Universiti Sains Malaysia, from June 2022 to May 2024, the study included 44 participants with mild to moderate depression. Twenty-two participants allocated in the ACT group received weekly group ACT sessions over four weeks, while twenty-two participants were assigned to the TAU group. Outcomes were measured using the Malay versions of the Beck Depression Inventory I (BDI), WHO Quality of Life-BREF (WHOQOL-BREF), and Acceptance and Action Questionnaire II (AAQ-II) at baseline, post-intervention, and at 3-month follow-up. Data was analyzed using two-way Repeated Measures Analysis of Variance (RM ANOVA) to assess changes in these outcomes across the different time points.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
44
The ACT intervention module utilized in this study was adapted from Hayes foundational work on ACT and Harris. A summary of the general contents and exercises in each week was in accordance with the 6 core processes of Acceptance and Commitment Therapy based on Hayes. It was conducted in the Malay language. The same workbook with guided exercise and homework were used by all the therapists to assure standardization of the intervention to ensure that each group received similar contents in each session.
Standard care and follow-up for major depressive disorder
Hospital Universiti Sains Malaysia
Kota Bharu, Kelantan, Malaysia
Depressive symptoms
The outcome was measured by using Beck Depression Inventory (BDI)
Time frame: From enrollment to the end of treatment at 4 weeks
Quality of life
The outcome was measured by using brief WHO Quality of Life (WHOQOL) questionnaire (Malay version)
Time frame: From enrollment to the end of treatment at 4 weeks
Psychological flexibility
The outcome was measured using Acceptance and Action Questionnaire II Malay Version (AAQ-II)
Time frame: From enrollment to the end of treatment at 4 weeks
Depressive symptoms (3 months)
It was measured using BDI at 3 months post-intervention
Time frame: 3 months post intervention
Quality of life (3 months)
It was measured using WHOQOL at 3 months post-intervention
Time frame: 3 months post intervention
Psychological flexibility (3 months)
It was measured using AAQ-II at 3 months post-intervention
Time frame: 3 months post intervention
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