Self-Help Plus for refugees and asylum seekers: an individual participant data meta-analysis.

Autor:	Karyotaki E; Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands e.karyotaki@vu.nl.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Sijbrandij M; Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Purgato M; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy., Acarturk C; Department of Psychology, Koc University, Istanbul, Turkey., Lakin D; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA., Bailey D; Department of Health Sciences, University of York, York, UK., Peckham E; Department of Health Sciences, University of York, York, UK., Uygun E; Department of Trauma and Disasters, Bilge University, Ankara, Turkey., Tedeschi F; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy., Wancata J; Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Augustinavicius J; Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA., Carswell K; Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland., Välimäki M; Department of Nursing Science, University of Turku, Turku, Finland.; Xiangya School of Nursing, The Xiangya Evidence-Based Practice and Healthcare Innovation, Central South University, Chang, People's Republic of China., van Ommeren M; Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland., Koesters M; Department of Psychiatry II, Ulm University, Ulm, Germany., Popa M; School of Psychology, Queen's University Belfast, Belfast, UK., Leku MR; HealthRight Uganda, Arua, Uganda., Anttila M; Department of Nursing Science, University of Turku, Turku, Finland., Churchill R; Centre for Reviews and Dissemination, University of York, York, UK., White RG; School of Psychology, Queen's University Belfast, Belfast, UK., Al-Hashimi S; Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Lantta T; Department of Nursing Science, University of Turku, Turku, Finland., Au T; Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland., Klein T; Department of Psychiatry II, Ulm University, Ulm, Germany., Tol WA; Xiangya School of Nursing, The Xiangya Evidence-Based Practice and Healthcare Innovation, Central South University, Chang, People's Republic of China., Cuijpers P; Department of Clinical, Neuro-, and Developmental Psychology and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Barbui C; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Jazyk:	angličtina
Zdroj:	BMJ mental health [BMJ Ment Health] 2023 Jul; Vol. 26 (1).
DOI:	10.1136/bmjment-2023-300672
Abstrakt:	Question: Refugees and asylum seekers are at high risk of mental disorders due to various stressors before, during and after forceful displacement. The WHO Self-Help Plus (SH+) intervention was developed to manage psychological distress and a broad range of mental health symptoms in vulnerable populations. This study aimed to examine the effects and moderators of SH+ compared with Enhanced Care as Usual (ECAU) in reducing depressive symptoms among refugees and asylum seekers. Study Selection and Analysis: Three randomised trials were identified with 1795 individual participant data (IPD). We performed an IPD meta-analysis to estimate the effects of SH+, primarily on depressive symptoms and second on post-traumatic stress, well-being, self-identified problems and functioning. Effects were also estimated at 5-6 months postrandomisation (midterm). Findings: There was no evidence of a difference between SH+ and ECAU+ in reducing depressive symptoms at postintervention. However, SH+ had significantly larger effects among participants who were not employed (β=1.60, 95% CI 0.20 to 3.00) and had lower mental well-being levels (β=0.02, 95% CI 0.001 to 0.05). At midterm, SH+ was significantly more effective than ECAU in improving depressive symptoms (β=-1.13, 95% CI -1.99 to -0.26), self-identified problems (β=-1.56, 95% CI -2.54 to -0.59) and well-being (β=6.22, 95% CI 1.60 to 10.90). Conclusions: Although SH+ did not differ significantly from ECAU in reducing symptoms of depression at postintervention, it did present benefits for particularly vulnerable participants (ie, unemployed and with lower mental well-being levels), and benefits were also evident at midterm follow-up. These results are promising for the use of SH+ in the management of depressive symptoms and improvement of well-being and self-identified problems among refugees and asylum seekers. Competing Interests: Competing interests: RGW acted as a consultant reviewer to the WHO in the development of the SH+ intervention, and I am an author on the papers reporting on the RCTs in the EU and Uganda. The rest of the authors have nothing to declare. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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