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Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis

Epidemiology and psychiatric sciences, 2019-08, Vol.28 (4), p.376-388 [Peer Reviewed Journal]

Copyright © Cambridge University Press 2019 ;2019 This article is published under (https://creativecommons.org/licenses/by/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Cambridge University Press 2019 2019 Cambridge University Press ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796019000027 ;PMID: 30739625

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  • Title:
    Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis
  • Author: 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.
  • Subjects: Acceptability ; Anxiety ; Clinical significance ; Conflicts of interest ; Displaced persons ; Effectiveness ; Epidemiology ; Health problems ; Mental depression ; Mental disorders ; Mental health ; Meta-analysis ; Political asylum ; Population ; Post traumatic stress disorder ; Posttraumatic stress disorder ; Psychiatry ; Quality of life ; Refugees ; Reviews ; Special ; Special Articles ; Systematic review ; Trauma
  • Is Part Of: Epidemiology and psychiatric sciences, 2019-08, Vol.28 (4), p.376-388
  • Description: 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. We 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. We 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. Considering 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.
  • Publisher: Cambridge, UK: Cambridge University Press
  • Language: English;Italian
  • Identifier: ISSN: 2045-7960
    EISSN: 2045-7979
    DOI: 10.1017/S2045796019000027
    PMID: 30739625
  • Source: ProQuest One Psychology
    Open Access: PubMed Central
    Journals@Ovid Open Access Journal Collection Rolling
    AUTh Library subscriptions: ProQuest Central
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