PLoS ONE
Volume 12, Issue 2, 2017

Psychosocial interventions for post-Traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-Analysis (Article) (Open Access)

Nosè M. , Ballette F. , Bighelli I. , Turrini G. , Purgato M. , Tol W. , Priebe S. , Barbui C.
  • a WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • b WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • c WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • d WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  • f Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • g WHO Collaborating Centre for Mental Health Services Development, Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
  • h WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

Abstract

Treatment of post-Traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms postintervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD4201502 7843. Twelve studies were included in the meta-Analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1.03, 95% CI -1.55 to -0.51; number needed to treat 4.4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-Term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0.78, 95% CI -1.18 to -0.38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in highincome countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future. © 2017 Nosè et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

refugee Implosive Therapy Randomized Controlled Trials as Topic randomized controlled trial (topic) Family Therapy human Refugees Developed Countries cognitive behavioral therapy narrative therapy cognitive therapy psychosocial care high income country meta analysis asylum seeker psychotherapy Humans psychology controlled clinical trial (topic) Article intervention study posttraumatic stress disorder developed country Stress Disorders, Post-Traumatic outcome assessment trauma focused psychotherapy Controlled Clinical Trials as Topic culture sensitive oriented peer systematic review clinical effectiveness
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85011382984&doi=10.1371%2fjournal.pone.0171030&partnerID=40&md5=db8a7e3c82925e709c7639bc26a95354
DOI: 10.1371/journal.pone.0171030
ISSN: 19326203
Cited by: 36
Original Language: English