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Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus

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 ORCID: 0000-0003-0744-2664, Morina, Naser, Moergeli, Hanspeter, Park, A-La ORCID: 0000-0002-4704-4874, Roberts, Bayard, Ventevogel, Peter, Wiedemann, Nana, Woodward, Aniek and Sijbrandij, Marit (2023) Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus. BMJ Mental Health, 26 (1). e300637. ISSN 2755-9734

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Identification Number: 10.1136/bmjment-2022-300637


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.

Item Type: Article
Additional Information: © 2023, The Author(s).
Divisions: Personal Social Services Research Unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences
Date Deposited: 10 Feb 2023 14:15
Last Modified: 14 Jul 2024 23:21

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