Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE) cluster-randomised controlled trial: An exploratory analysis of impact on food insecurity, underweight, alcohol use disorder and depressive symptoms

Asher, Laura; Birhane, Rahel; Weiss, Helen; Medhin, Girmay; Selamu, Medhin; Patel, Vikram; de Silva, Mary; Hanlon, Charlotte; Fekadu, Abebaw

Abstract

We evaluated the effectiveness of community-based rehabilitation (CBR) in reducing depressive symptoms, alcohol use disorder, food insecurity and underweight in people with schizophrenia. This cluster-randomised controlled trial was conducted in a rural district of Ethiopia. Fifty-four sub-districts were allocated in a 1:1 ratio to the facility-based care [FBC] plus CBR arm and the FBC alone arm. Lay workers delivered CBR over 12 months. We assessed food insecurity (self-reported hunger), underweight (BMI< 18.5 kg/m2), depressive symptoms (PHQ-9) and alcohol use disorder (AUDIT ≥ 8) at 6 and 12 months. Seventy-nine participants with schizophrenia in 24 sub-districts were assigned to CBR plus FBC and 87 participants in 24 sub-districts were assigned to FBC only. There was no evidence of an intervention effect on food insecurity (aOR 0.52, 95% CI 0.16–1.67; p = 0.27), underweight (aOR 0.44, 95% CI 0.17–1.12; p = 0.08), alcohol use disorder (aOR 0.82, 95% CI 0.24–2.74; p = 0.74) or depressive symptoms (adjusted mean difference − 0.06, 95% CI −1.35, 1.22; p = 0.92). Psychosocial interventions in low-resource settings should support access to treatment amongst people with schizophrenia, and further research should explore how impacts on economic, physical and mental health outcomes can be achieved.

Citation

Asher, L., Birhane, R., Weiss, H., Medhin, G., Selamu, M., Patel, V., …Fekadu, A. (2023). Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE) cluster-randomised controlled trial: An exploratory analysis of impact on food insecurity, underweight, alcohol use disorder and depressive symptoms. Cambridge Prisms: Global Mental Health, 10, Article E70. https://doi.org/10.1017/gmh.2023.67

• Journal Article Type: Article
• Acceptance Date: Oct 18, 2023
• Online Publication Date: Oct 25, 2023
• Publication Date: 2023
• Deposit Date: Nov 7, 2023
• Publicly Available Date: Nov 7, 2023
• Print ISSN: 2054-4251
• Electronic ISSN: 2054-4251
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Article Number: E70
• DOI: https://doi.org/10.1017/gmh.2023.67
• Public URL: https://nottingham-repository.worktribe.com/output/27075300
• Publisher URL: https://www.cambridge.org/core/journals/global-mental-health/article/communitybased-rehabilitation-intervention-for-people-with-schizophrenia-in-ethiopia-rise-clusterrandomized-controlled-trial-an-exploratory-analysis-of-impact-on-food-insecurity-underwei