Etheldreda Nakimuli-Mpungu

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Etheldreda Nakimuli-Mpungu
Dr Etheldreda Nakmuli Mpungu Uganda (sq cropped).png
Born1974 (age 49–50)
Alma mater Johns Hopkins University
Occupation(s)Psychiatrist; Academic; Mental health advocate
Employer Makerere University
Awards Elsevier Foundation Award (2016), BBC 100 Women (2020)

Etheldreda Nakimuli-Mpungu (born 1974) is a professor, researcher, epidemiologist and psychiatrist at the Department of Psychiatry in the Faculty of Medicine, Makerere University in Uganda. Her research is particularly focused on supportive group psychotherapy as a first-line treatment for depression in people with HIV. She is one of only five recipients of the Elsevier Foundation Award for Early Career Women Scientists in the Developing World in Biological Sciences, as well as listed at one of the BBC's 100 Women in 2020.

Contents

Education

Nakimuli-Mpungu graduated in Medicine from Makerere University's Faculty of Health Sciences in 1998. [1] When she announced the news to her mother, her mother replied: “OK, good. But you know it's not good just to be a doctor, you go to some doctors and they don't make you feel better. I want you to be one of the doctors who really do good for people". [2] Her career began in Kampala, where she worked first in a surgical department, then with children. [2] From 2001 to 2012 she worked in psychiatric care at Butabika National Referral Mental Hospital. [1] In 2006, she is also resumed graduate studies in Psychiatry at Makerere University's College of Health Sciences and was awarded an MA. [1] In 2012, she was awarded a doctorate in psychiatric epidemiology from Johns Hopkins University. [1]

Career

Whilst working at Butabika Hospital, Nakimuli-Mpungu noticed a large number of HIV/AIDS patients were being admitted with serious mental health problems. [2] Nakimuli-Mpungu commented that "at the time, nobody knew how to help them or what to do with them", specifying that "there was this idea in the medical community that these people were beyond all help". [2] She undertook her own observations, which confirmed the HIV-positive individuals are more likely to be diagnosed with depression, in part due to the stigma surrounding the disease. [2] One symptom of depression is neglect of self-care, which means for some HIV patients, they are less likely to take their medication. [2] Nakimuli-Mpungu felt that there could be a dual approach to the two diseases, but there was nothing published in scientific literature at the time, which could serve as a basis for implementation of such a treatment. [2]

Nakimuli-Mpungu then launched a research programme to explore the possibilities of a treatment that addressed both issues. Since most medical centres in Uganda lack funding, as well as training for and staff to work on mental health care, Nakimuli-Mpungu focussed on the potential of group therapy as a treatment. Her first pilot recruited 150 people with HIV and depression. The recruits were split into two groups: one group received Nakimuli-Mpungu's group therapy sessions, the other standard HIV education sessions at a clinic. Whilst over time all patients depression decreased, significantly the group therapy's trend was a continuation of decrease of depression even after the sessions ceased. [2]

This initial study led to a larger programme, which began in 2016. [3] In this iteration, 1140 patients were treated at over 40 health centres across northern Uganda. [4] The participants were again split into two: one half received "culturally appropriate psychotherapy", the others received general HIV education. [4] The treatments this time were provided by trained, non-professional healthcare workers over a course of eight weeks. [4] The group that received psychotherapy showed less incidences of major depression than the other group, reduced symptoms of PTSD, greater adherence to medication courses, lower rates of alcohol abuse, amongst other outcomes. [4] Positive affects were greatest amongst male patients. [4]

As of 2020 she is a professor, researcher, epidemiologist and psychiatrist at the Department of Psychiatry in the Faculty of Medicine, Makerere University. [5]

Awards

Selected publications

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

<span class="mw-page-title-main">Major depressive disorder</span> Mental disorder involving persistent low mood, low self-esteem, and loss of interest

Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since.

Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. The term can legitimately refer to any form of psychotherapy when delivered in a group format, including art therapy, cognitive behavioral therapy or interpersonal therapy, but it is usually applied to psychodynamic group therapy where the group context and group process is explicitly utilized as a mechanism of change by developing, exploring and examining interpersonal relationships within the group.

<span class="mw-page-title-main">Hypochondriasis</span> Medical condition

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.

Cognitive analytic therapy (CAT) is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK's National Health Service with the aim of providing effective and affordable psychological treatment which could be realistically provided in a resource constrained public health system. It is distinctive due to its intensive use of reformulation, its integration of cognitive and analytic practice and its collaborative nature, involving the patient very actively in their treatment.

Treatment-resistant depression is a term used in psychiatry to describe people with major depressive disorder (MDD) who do not respond adequately to a course of appropriate antidepressant medication within a certain time. Definitions of treatment-resistant depression vary, and they do not include a resistance to psychological therapies. Inadequate response has most commonly been defined as less than 50% reduction in depressive symptoms following treatment with at least one antidepressant medication, although definitions vary widely. Some other factors that may contribute to inadequate treatment are: a history of repeated or severe adverse childhood experiences, early discontinuation of treatment, insufficient dosage of medication, patient noncompliance, misdiagnosis, cognitive impairment, low income and other socio-economic variables, and concurrent medical conditions, including comorbid psychiatric disorders. Cases of treatment-resistant depression may also be referred to by which medications people with treatment-resistant depression are resistant to. In treatment-resistant depression adding further treatments such as psychotherapy, lithium, or aripiprazole is weakly supported as of 2019.

Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.

<span class="mw-page-title-main">Psychological intervention</span>

In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.

Early intervention in psychosis is a clinical approach to those experiencing symptoms of psychosis for the first time. It forms part of a new prevention paradigm for psychiatry and is leading to reform of mental health services, especially in the United Kingdom and Australia.

Late-life depression refers to depression occurring in older adults and has diverse presentations, including as a recurrence of early-onset depression, a new diagnosis of late-onset depression, and a mood disorder resulting from a separate medical condition, substance use, or medication regimen. Research regarding late-life depression often focuses on late-onset depression, which is defined as a major depressive episode occurring for the first time in an older person.

The mainstay of management of borderline personality disorder is various forms of psychotherapy with medications being found to be of little use.

Butabika National Referral Hospital, commonly known as Butabika Hospital is a hospital in Kampala, Uganda's capital and largest city. It is the mental health national referral hospital for the entire country's estimated population of 36 million in 2014.

Dr. Allan Abbass is professor, psychiatrist, and founding Director of the Centre for Emotions and Health at Dalhousie University in Halifax, Nova Scotia, Canada.

Relapse prevention (RP) is a cognitive-behavioral approach to relapse with the goal of identifying and preventing high-risk situations such as unhealthy substance use, obsessive-compulsive behavior, sexual offending, obesity, and depression. It is an important component in the treatment process for alcohol use disorder, or alcohol dependence. This model founding is attributed to Terence Gorski's 1986 book "Staying Sober."

Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.

PSYCHLOPS is a type of psychological testing, a tool used in primary care to measure mental health outcomes and as a quality of life measure.

Fred Nalugoda is a public health researcher studying HIV/AIDS in rural Uganda for over 20 years, mainly through surveillance and field work. He currently serves as the Program Director of a research station in Kalisizo in Uganda as part of his continued work at the Rakai Health Sciences Program (RHSP).

DIALOG+ is an intervention that uses technology to guide conversations between patients and their health providers during routine appointments. The intervention aims to help patients identify strategies to improve their quality of life, using resources already available to them. The DIALOG+ intervention is available for Android and Apple operating systems, and is also available as a progressive web application.

Claudi Bockting is a Dutch clinical psychologist and Professor of Clinical Psychology in Psychiatry at the University of Amsterdams Faculty of Medicine, Amsterdam University Medical Centers. Her research program focuses on identifying etiological factors of common mental health disorders such as depression, anxiety disorders and substance abuse, and developing evidence-based psychotherapeutic interventions.

Melanie Amna Abas is a British psychiatric epidemiologist who is Professor of Global Mental Health at the Institute of Psychiatry, Psychology and Neuroscience. She is a consultant psychiatrist at the South London and Maudsley NHS Foundation Trust, co-director of the NIHR Global Health Research Group African Youth in Mind, and leads the National Institutes of Health TENDAI Clinical Trial.

References

  1. 1 2 3 4 "Etheldreda Nakimuli-Mpungu". Mental Health Innovation Network. Retrieved 8 January 2021.
  2. 1 2 3 4 5 6 7 8 "Mom Inspires Daughter To Be A Doctor Who Really Makes People Better". text.npr.org. Retrieved 8 January 2021.
  3. ↑ "The effects of group support psychotherapy delivered by lay health workers on depression among persons living with HIV in Northern Uganda | MQ Mental Health Research". www.mqmentalhealth.org. 27 October 2020. Retrieved 10 January 2021.
  4. 1 2 3 4 5 "Group psychotherapy led by lay health workers can dramatically improve depression in people with HIV, says Ugandan study". aidsmap.com. Retrieved 10 January 2021.
  5. 1 2 "Etheldreda Nakimuli-Mpungu". Women Leaders in Global Health. Retrieved 10 January 2021.
  6. 1 2 3 "Etheldreda Nakimuli-Mpungu". The Conversation. Retrieved 10 January 2021.
  7. ↑ "BBC 100 Women 2020: Who is on the list this year?". BBC News. 23 November 2020. Retrieved 10 January 2021.
  8. ↑ Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Wamala, Kizito; Okello, James; Ndyanabangi, Sheila; Birungi, Josephine; Nanfuka, Mastula; Etukoit, Micheal; Mayora, Chrispus; Ssengooba, Freddie; Mojtabai, Ramin (2020). "Effectiveness and cost-effectiveness of group support psychotherapy delivered by trained lay health workers for depression treatment among people with HIV in Uganda: a cluster-randomised trial". The Lancet Global Health. 8 (3): e387–e398. doi: 10.1016/s2214-109x(19)30548-0 . ISSN   2214-109X. PMID   32035035.
  9. ↑ Nakimuli-Mpungu, Etheldreda; Wamala, Kizito; Okello, James; Alderman, Stephen; Odokonyero, Raymond; Mojtabai, Ramin; Mills, Edward J; Kanters, Steve; Nachega, Jean B; Musisi, Seggane (2015). "Group support psychotherapy for depression treatment in people with HIV/AIDS in northern Uganda: a single-centre randomised controlled trial". The Lancet HIV. 2 (5): e190–e199. doi:10.1016/S2352-3018(15)00041-7. PMID   26423001.
  10. ↑ Nakimuli-Mpungu, Etheldreda; Bass, Judith K.; Alexandre, Pierre; Mills, Edward J.; Musisi, Seggane; Ram, Malathi; Katabira, Elly; Nachega, Jean B. (2012). "Depression, Alcohol Use and Adherence to Antiretroviral Therapy in Sub-Saharan Africa: A Systematic Review". AIDS and Behavior. 16 (8): 2101–2118. doi:10.1007/s10461-011-0087-8. ISSN   1090-7165. PMID   22116638. S2CID   20423425.
  11. ↑ Park, Jay J H; Grais, Rebecca F; Taljaard, Monica; Nakimuli-Mpungu, Etheldreda; Jehan, Fyezah; Nachega, Jean B; Ford, Nathan; Xavier, Denis; Kengne, Andre P; Ashorn, Per; Socias, Maria Eugenia; Bhutta, Zulfiqar A; Mills, Edward J (1 May 2021). "Urgently seeking efficiency and sustainability of clinical trials in global health". The Lancet Global Health. 9 (5): e681–e690. doi:10.1016/S2214-109X(20)30539-8. ISSN   2214-109X. PMC   8424133 . PMID   33865473.
  12. ↑ Anyayo, Lucas; Ashaba, Scholastic; Kaggwa, Mark Mohan; Maling, Samuel; Nakimuli-Mpungu, Etheldreda (10 March 2021). "Health-related quality of life among patients with bipolar disorder in rural southwestern Uganda: a hospital based cross sectional study". Health and Quality of Life Outcomes. 19 (1): 84. doi: 10.1186/s12955-021-01729-5 . ISSN   1477-7525. PMC   7945052 . PMID   33691720.
  13. ↑ Nakimuli-Mpungu, Etheldreda; Smith, Colin M.; Wamala, Kizito; Okello, James; Birungi, Josephine; Etukoit, Micheal; Mojtabai, Ramin; Nachega, Jean B.; Harari, Ofir; Musisi, Seggane; Mills, Edward J. (2022). "Long-Term Effect of Group Support Psychotherapy on Depression and HIV Treatment Outcomes: Secondary Analysis of a Cluster Randomized Trial in Uganda". Psychosomatic Medicine. 84 (8): 914–923. doi:10.1097/PSY.0000000000001128. ISSN   1534-7796. PMC   9553261 . PMID   36162067.
  14. ↑ Hunter, Sharon K (2020). "Black American Maternal Prenatal Choline, Offspring Gestational Age at Birth, and Developmental Predisposition to Mental Illness". Schizophrenia Bulletin. pp. 896–905. doi:10.1093/schbul/sbaa171. PMC   8266582 . PMID   33184653 . Retrieved 1 February 2023.
  15. ↑ Nakimuli-Mpungu, Etheldreda; Okello, James; Kinyanda, Eugene; Alderman, Stephen; Nakku, Juliet; Alderman, Jeffrey S.; Pavia, Alison; Adaku, Alex; Allden, Kathleen; Musisi, Seggane (1 October 2013). "The impact of group counseling on depression, post-traumatic stress and function outcomes: A prospective comparison study in the Peter C. Alderman trauma clinics in northern Uganda". Journal of Affective Disorders. 151 (1): 78–84. doi: 10.1016/j.jad.2013.05.055 . ISSN   0165-0327. PMID   23787406.
  16. ↑ Park, Jay J H; Mogg, Robin; Smith, Gerald E; Nakimuli-Mpungu, Etheldreda; Jehan, Fyezah; Rayner, Craig R; Condo, Jeanine; Decloedt, Eric H; Nachega, Jean B; Reis, Gilmar; Mills, Edward J (1 May 2021). "How COVID-19 has fundamentally changed clinical research in global health". The Lancet Global Health. 9 (5): e711–e720. doi:10.1016/S2214-109X(20)30542-8. ISSN   2214-109X. PMC   8049590 . PMID   33865476.
  17. ↑ Karyotaki, Eirini; Araya, Ricardo; Kessler, Ronald C.; Waqas, Ahmed; Bhana, Arvin; Rahman, Atif; Matsuzaka, Camila T.; Miguel, Clara; Lund, Crick; Garman, Emily C.; Nakimuli-Mpungu, Etheldreda; Petersen, Inge; Naslund, John A.; Schneider, Marguerite; Sikander, Siham (1 May 2022). "Association of Task-Shared Psychological Interventions With Depression Outcomes in Low- and Middle-Income Countries: A Systematic Review and Individual Patient Data Meta-analysis". JAMA Psychiatry. 79 (5): 430–443. doi:10.1001/jamapsychiatry.2022.0301. hdl:1871.1/1b2c8ab9-7e97-4708-bbee-ccbd2d09e6a0. ISSN   2168-622X. PMC   8943620 . PMID   35319740.
  18. ↑ Dron, Louis; Taljaard, Monica; Cheung, Yin Bun; Grais, Rebecca; Ford, Nathan; Thorlund, Kristian; Jehan, Fyezah; Nakimuli-Mpungu, Etheldreda; Xavier, Denis; Bhutta, Zulfiqar A.; Park, Jay J. H.; Mills, Edward J. (1 May 2021). "The role and challenges of cluster randomised trials for global health". The Lancet Global Health. 9 (5): e701–e710. doi: 10.1016/S2214-109X(20)30541-6 . ISSN   2214-109X. PMID   33865475. S2CID   233298976.
  19. ↑ Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Wamala, Kizito; Okello, James; Ndyanabangi, Sheila; Birungi, Josephine; Nanfuka, Mastula; Etukoit, Micheal; Mayora, Chrispus; Ssengooba, Freddie; Mojtabai, Ramin; Nachega, Jean B; Harari, Ofir; Mills, Edward J (1 March 2020). "Effectiveness and cost-effectiveness of group support psychotherapy delivered by trained lay health workers for depression treatment among people with HIV in Uganda: a cluster-randomised trial". The Lancet Global Health. 8 (3): e387–e398. doi: 10.1016/S2214-109X(19)30548-0 . ISSN   2214-109X. PMID   32035035. S2CID   211066979.
  20. ↑ Nakimuli‐Mpungu, Etheldreda; Musisi, Seggane; Smith, Colin M; Von Isenburg, Megan; Akimana, Benedict; Shakarishvili, Ani; Nachega, Jean B; Mills, Edward J; Chibanda, Dixon; Ribeiro, Marcelo; V Williams, Anna; Joska, John A (2021). "Mental health interventions for persons living with HIV in low‐ and middle‐income countries: a systematic review". Journal of the International AIDS Society. 24 (S2): e25722. doi:10.1002/jia2.25722. ISSN   1758-2652. PMC   8222847 . PMID   34164926.
  21. ↑ Nalugya-Sserunjogi, Joyce; Rukundo, Godfrey Zari; Ovuga, Emilio; Kiwuwa, Steven M.; Musisi, Seggane; Nakimuli-Mpungu, Etheldreda (26 October 2016). "Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda". Child and Adolescent Psychiatry and Mental Health. 10 (1): 39. doi: 10.1186/s13034-016-0133-4 . ISSN   1753-2000. PMC   5081935 . PMID   27800012.
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