Effectiveness of a WHO self-help psychological intervention for preventing mental disorders among Syrian refugees in Turkey: a randomized controlled trial
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Dosyalar
Tarih
2022-02
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
WILEY
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Abstract: Refugees are at high risk of developing mental disorders. There is no evidence from randomized controlled trials (RCTs) that psychological interventions can prevent the onset of mental disorders in this group. We assessed the effectiveness of a selfhelp psychological intervention developed by the World Health Organization, called SelfHelp Plus, in preventing the development of mental disorders among Syrian refugees experiencing psychological distress in Turkey. A twoarm, assessormasked RCT was conducted in two Turkish areas. Eligible participants were adult Syrian refugees experiencing psychological distress (General Health Questionnaire ?3), but without a diagnosis of mental disorder. They were randomly assigned either to the SelfHelp Plus arm (consisting of SelfHelp Plus combined with Enhanced Care as Usual, ECAU) or to ECAU only in a 1:1 ratio. SelfHelp Plus was delivered in a group format by two facilitators over five sessions. The primary outcome measure was the presence of any mental disorder assessed by the Mini International Neuropsychiatric Interview at sixmonth followup. Secondary outcome measures were the presence of mental disorders at postintervention, and psychological distress, symptoms of posttraumatic stress disorder and depression, personally identified psychological outcomes, functional impairment, subjective wellbeing, and quality of life at postintervention and sixmonth followup. Between October 1, 2018 and November 30, 2019, 1,186 refugees were assessed for inclusion. Five hundred fortyfour people were ineligible, and 642 participants were enrolled and randomly assigned to either SelfHelp Plus (N=322) or ECAU (N=320). SelfHelp Plus participants were significantly less likely to have any mental disorders at sixmonth followup compared to the ECAU group (21.69% vs. 40.73%; Cramer’s V = 0.205, p<0.001, risk ratio: 0.533, 95% CI: 0.4080.696). Analysis of secondary outcomes suggested that SelfHelp Plus was not effective immediately postintervention, but was associated with beneficial effects at sixmonth followup in terms of symptoms of depression, personally identified psychological outcomes, and quality of life. This is the first prevention RCT ever conducted among refugees experiencing psychological distress but without a mental disorder. SelfHelp Plus was found to be an effective strategy for preventing the onset of mental disorders. Based on these findings, this lowintensity selfhelp psychological intervention could be scaled up as a public health strategy to prevent mental disorders in refugee populations exposed to ongoing adversities
Açıklama
Anahtar Kelimeler
Refugees, prevention, common mental disorders, common mental disorders, Self-Help Plus, psychological intervention
Kaynak
WORLD PSYCHIATRY
WoS Q Değeri
Q1
