Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus. Issue 1 (8th February 2023)

• Record Type: Journal Article
• Authors: de Graaff, Anne M; Cuijpers, Pim; Twisk, Jos W R; Kieft, Barbara; Hunaidy, Sam; Elsawy, Mariam; Gorgis, Noer; Bouman, Theo K; Lommen, Miriam J J; Acarturk, Ceren; Bryant, Richard; Burchert, Sebastian; Dawson, Katie S; Fuhr, Daniela C; Hansen, Pernille; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Morina, Naser; Moergeli, Hanspeter; Park, A-La; Roberts, Bayard; Ventevogel, Peter; Wiedemann, Nana; Woodward, Aniek; Sijbrandij, Marit
• Other Names: author non-byline.; Acarturk Ceren author non-byline.; Akhtar Aemal author non-byline.; Bawaneh Akinçi Ahmad author non-byline.; Bird Martha author non-byline.; Brown Felicity author non-byline.; Bryant Richard author non-byline.; Burchert Sebastian author non-byline.; Cuijpers Pim author non-byline.; Dool Martine van den author non-byline.; Graaff Anne de author non-byline.; Drogendijk Annelieke author non-byline.; Fuhr Daniela author non-byline.; Hemmo Mahmoud author non-byline.; Hessling Jonas Maria author non-byline.; Ilkkursun Zeynep author non-byline.; Jordans Mark author non-byline.; Kiselev Nikolai author non-byline.; Knaevelsrud Christine author non-byline.; Kurt Gülşah author non-byline.; Martinmäki Saara author non-byline.; McDaid David author non-byline.; Mirzanlı Cansu author non-byline.; Mooren Trudy author non-byline.; Morina Naser author non-byline.; Park A-La author non-byline.; Roberts Bayard author non-byline.; Schick Matthis author non-byline.; Schnyder Ulrich author non-byline.; Sijbrandij Marit author non-byline.; Sondorp Egbert author non-byline.; Spaaij Julia author non-byline.; Steen Frederik author non-byline.; Taha Karine author non-byline.; Ventevogel Peter author non-byline.; Whitney Claire author non-byline.; Wiedemann Nana author non-byline.; Woodward Aniek author non-byline.; Pfaltz Monique author non-byline.;
• Is Part Of: BMJ mental health. Volume 26:Issue 1(2023)
• Publication Date: 2023-02-08
• Subjects: Depression & mood disorders -- Anxiety disorders -- Adult psychiatry; 616.89
• DOI: 10.1136/bmjment-2022-300637
• Languages: English
• ISSNs: 2755-9734

Abstract

Abstract : Background: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited. Objective: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands. Methods: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019–December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat. Findings: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference −0.25; 95% CI −0.385 to −0.122; p=0.0001, Cohen's d =0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d =0.42), anxiety (p=0.001, Cohen's d =0.27), PTSD symptoms (p=0.0005, Cohen's d =0.39) and self-identified problems (p=0.03, Cohen's d =0.26), but not on impairment (p=0.084, Cohen's d =0.21). Conclusions: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit. Clinical implications: Peer-provided psychological interventions should be considered for scale-up in HICs.