Abstract
<title>Abstract</title> <p>Background Injuries from trauma constitute a huge burden on mental health in sub-Saharan Africa (SSA); nevertheless, there is little to no community-based, evidence-based psychological intervention for patients with traumatic injuries in LMICs. The Friendship Bench refers to a brief and problem-solving therapy (PST) intervention by trained layhealthworkers that has proven effective in the management of common mental disorders. However, the effect of the Friendship Bench on individuals with traumatic injuries who seek treatment at hospitals has not been established. This study sought to evaluate the relationship between the Friendship Bench intervention and depression among trauma victims in Cameroon. Methods A pre-post design quasi-experiment with a control group was conducted in three hospitals in Cameroon: two intervention sites (Hôpital Laquintinie de Douala; (HLD) and the Regional Hospital of Bertoua; (BRH)) and one control site (Regional Hospital of Maroua; (HRM)). All patients were screened for clinically significant depressive symptoms at baseline using the PHQ-8 score (≥ 10). Patients in the intervention group participated in six structured sessions on the Friendship Bench, with depressive symptoms evaluated at two time points; one month post-hospital discharge (T0) and at the completion of the Friendship Bench session (T1) using the PHQ-8. Results Twenty-one participants were enrolled (median age 33.0 years (IQR: 26.0–48.0); 86% male). Baseline PHQ-8 scores were comparable between groups (Friendship Bench: 13.29 ± 2.61; Control: 13.00 ± 1.91). At follow-up, the Friendship Bench group demonstrated a median PHQ-8 reduction of 9.00 points (IQR: 8.00–11.75; Wilcoxon V = 0, p = 0.0011), compared with a median reduction of 4.00 points in the control group (IQR:0.50–4.50; Wilcoxon V = 0, p = 0.058). The between group difference in PHQ-8 change scores was statistically significant (Mann-Whitney U W = 7, p = 0.0019). Clinical response (≥ 50% PHQ-8 reduction) was achieved by 92.9% of the Friendship Bench group versus 14.3% of controls. Remission (PHQ-8 < 5) was achieved by 71.4% versus 14.3%, respectively. Conclusion The Friendship Bench approach significantly reduced depression symptoms in patients with traumatic injuries in Cameroon, substantially outperforming the control group. These findings support the potential of task-shifted psychosocial therapies in low-resource settings for trauma care and justify larger randomized trials.</p>