Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis
| Autor: | Martha Bird, Francesca Ballette, Markus Kösters, Giovanni Ostuzzi, L J Hansen, Kenneth Carswell, Rachel Churchill, Maritta Välimäki, M van Ommeren, Pim Cuijpers, Federico Tedeschi, Giulia Turrini, Minna Anttila, Johannes Wancata, J Hall, Ross G. White, Michela Nosè, Marit Sijbrandij, Marianna Purgato, Teresa Au, Ceren Acarturk, Tella Lantta, Corrado Barbui |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty psychosocial interventions Epidemiology Refugee Asylum seekers Population Psychological intervention Anxiety mental health refugees Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Outcome Assessment Health Care Medicine Humans 030212 general & internal medicine education Psychiatry Randomized Controlled Trials as Topic education.field_of_study business.industry Depression Public Health Environmental and Occupational Health SDG 10 - Reduced Inequalities Patient Acceptance of Health Care Mental health 030227 psychiatry 3. Good health Psychotherapy Psychiatry and Mental health Meta-analysis Special Articles Female medicine.symptom business Psychosocial Stress Psychological |
| Zdroj: | Epidemiology and Psychiatric Sciences Vrije Universiteit Amsterdam Turrini, G, Purgato, M, Acarturk, C, Anttila, M, Au, T, Ballette, F, Bird, M, Carswell, K, Churchill, R, Cuijpers, P, Hall, J, Hansen, L J, Kösters, M, Lantta, T, Nosè, M, Ostuzzi, G, Sijbrandij, M, Tedeschi, F, Valimaki, M, Wancata, J, White, R, Van Ommeren, M & Barbui, C 2019, ' Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees : Systematic review and meta-analysis ', Epidemiology and Psychiatric Sciences, vol. 28, no. 4, pp. 376-388 . https://doi.org/10.1017/S2045796019000027 |
| ISSN: | 2045-7960 2045-7979 |
| DOI: | 10.1017/S2045796019000027 |
| Popis: | AimsIn the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.MethodsWe used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.ResultsWe included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = −0.71; 95% confidence interval [CI] −1.01 to −0.41; I2 = 83%; 95% CI 78–88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = −1.02; 95% CI −1.52 to −0.51; I2 = 89%; 95% CI 82–93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = −1.05; 95% CI −1.55 to −0.56; I2 = 87%; 95% CI 79–92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.ConclusionsConsidering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly. |
| Databáze: | OpenAIRE |
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