Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial
Ilkkursun Zeynep; van Ommeren Mark; Baumgartner Josef; Turrini Giulia; Churchill Rachel; Popa Mariana; Cuijpers Pim; Carswell Kenneth; Barbui Corrado; Purgato Marianna; Wancata Johannes; Gastaldon Chiara; Anttila Minna; Roselli Valentina; Ostuzzi Giovanni; Sijbrandij Marit; Bajbouj Malek; Papola Davide; White Ross; Biondi Massimo; Välimäki Maritta; Koesters Markus; Lantta Tella; Tarsitani Lorenzo; Tedeschi Federico; Au Teresa; Acarturk Ceren; Walker Lauren; Nose Michela; Zanini Elisa
https://urn.fi/URN:NBN:fi-fe2021093048909
Tiivistelmä
Introduction
Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress.
Objective
To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe.
Methods
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.
Results
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 V = 0.007, p = 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 V = 0.13, p = 0.01, RR = 0.50; 95% CI 0.29-0.87).
Conclusions
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.
Kokoelmat
- Rinnakkaistallenteet [19207]