Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/81535
Title: Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees : systematic review and meta-analysis
Authors: Turrini, G
Purgato, M
Acarturk, C
Anttila, M
Au, T
Ballette, F
Bird, M
Carswell, K
Churchill, R
Cuijpers, P
Hall, J
Hansen, LJ
Kösters, M
Lantta, T
Nosè, M
Ostuzzi, G
Sijbrandij, M
Tedeschi, F
Valimaki, M 
Wancata, J
White, R
Van, Ommeren, M
Barbui, C
Keywords: Asylum seekers
Mental health
Psychosocial interventions
Refugees
Issue Date: 2019
Publisher: Cambridge University Press
Source: Epidemiology and psychiatric sciences, 2019, v. 28, no. 4, p. 376-388 How to cite?
Journal: Epidemiology and psychiatric sciences 
Abstract: Aims: In the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.
Methods: We used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.
Results: We included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = ?irc;'0.71; 95% confidence interval [CI] ?irc;'1.01 to ?irc;'0.41; I 2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = ?irc;'1.02; 95% CI ?irc;'1.52 to ?irc;'0.51; I 2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = ?irc;'1.05; 95% CI ?irc;'1.55 to ?irc;'0.56; I 2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.
Conclusions: Considering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly.
URI: http://hdl.handle.net/10397/81535
ISSN: 2045-7960
EISSN: 2045-7979
DOI: 10.1017/S2045796019000027
Rights: © Cambridge University Press 2019. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
The following publication Turrini G et al (2019). Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiology and Psychiatric Sciences 28, 376–388, is available at https://doi.org/10.1017/S2045796019000027
Appears in Collections:Journal/Magazine Article

Files in This Item:
File Description SizeFormat 
Turrini_Efficacy_acceptability_psychosocial.pdf712.97 kBAdobe PDFView/Open
Access
View full-text via PolyU eLinks SFX Query
Show full item record
PIRA download icon_1.1View/Download Contents

SCOPUSTM   
Citations

4
Citations as of Jan 12, 2020

Page view(s)

30
Citations as of Jan 22, 2020

Download(s)

15
Citations as of Jan 22, 2020

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.