Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial



Purgato, Marianna, Carswell, Kenneth, Tedeschi, Federico, Acarturk, Ceren, Anttila, Minna, Au, Teresa, Bajbouj, Malek, Baumgartner, Josef, Biondi, Massimo, Churchill, Rachel
et al (show 20 more authors) (2021) Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial. Psychotherapy and Psychosomatics. 1 - 12.

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Abstract

<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We conducted a randomized controlled trial in 5 European countries. Refugees and asylum seekers with psychological distress (General Health Questionnaire score ≥3), but without a Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or ICD/10 diagnosis of mental disorder, as assessed with the Mini International Neuropsychiatric Interview (MINI), were randomized to SH+ or enhanced treatment as usual (ETAU). The primary outcome was the frequency of mental disorders with the MINI at 6 months. Secondary outcomes included the frequency of mental disorders at postintervention, self-identified problems, psychological symptoms, and other outcomes. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Four hundred fifty-nine individuals were randomly assigned to SH+ or ETAU. For the primary outcome, we found no difference in the frequency of mental disorders at 6 months (Cramer &lt;i&gt;V&lt;/i&gt; = 0.007, &lt;i&gt;p&lt;/i&gt; = 0.90, RR = 0.96; 95% CI 0.52–1.78), while the difference significantly favored SH+ at after the intervention (secondary outcome, measured within 2 weeks from the last session; Cramer &lt;i&gt;V&lt;/i&gt; = 0.13, &lt;i&gt;p&lt;/i&gt; = 0.01, RR = 0.50; 95% CI 0.29–0.87). &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; This is the first randomized indicated prevention study with the aim of preventing the onset of mental disorders in asylum seekers and refugees in Western Europe. As a prevention effect of SH+ was not observed at 6 months, but rather after the intervention only, modalities to maintain its beneficial effect in the long term need to be identified. </jats:p>

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 06 Aug 2021 07:00
Last Modified: 07 Sep 2022 00:11
DOI: 10.1159/000517504
URI: https://livrepository.liverpool.ac.uk/id/eprint/3132506