The effectiveness of Problem Management Plus at 1-year follow-up for Syrian refugees in a high-income setting

de Graaff, Anne M., Cuijpers, Pim, Elsawy, Mariam, Hunaidy, Sam, Kieft, Barbara, Gorgis, Noer, Twisk, Jos W. R., Zakarian, Yenovk, Bouman, Theo K., Lommen, Miriam J. J., Acarturk, Ceren, Bryant, Richard, McDaid, David ORCID: 0000-0003-0744-2664, Morina, Naser, Park, A-La ORCID: 0000-0002-4704-4874, Ventevogel, Peter and Sijbrandij, Marit (2024) The effectiveness of Problem Management Plus at 1-year follow-up for Syrian refugees in a high-income setting. Epidemiology and Psychiatric Sciences, 33. ISSN 2045-7960

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Abstract

Aims Problem Management Plus (PM+) has been effective in reducing mental health problems among refugees at three-month follow-up, but there is a lack of research on its long-term effectiveness. This study examined the effectiveness of PM+ in reducing symptoms of common mental disorders at 12-month follow-up among Syrian refugees in the Netherlands. Methods This single-blind, parallel, controlled trial randomised 206 adult Syrians who screened positive for psychological distress and impaired functioning to either PM+ in addition to care as usual (PM+/CAU) or CAU alone. Assessments were at baseline, 1 week and 3 months after the intervention and 12 months after baseline. Outcomes were psychological distress (Hopkins Symptom Checklist [HSCL-25]), depression (HSCL-25 subscale), anxiety (HSCL-25 subscale), posttraumatic stress disorder symptoms (PCL-5), functional impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS). Results In March 2019–December 2022, 103 participants were assigned to PM+/CAU and 103 to CAU of which 169 (82.0%) were retained at 12 months. Intention-to-treat analyses showed greater reductions in psychological distress at 12 months for PM+/CAU compared to CAU (adjusted mean difference −0.17, 95% CI −0.310 to −0.027; p = 0.01, Cohen’s d = 0.28). Relative to CAU, PM+/CAU participants also showed significant reductions on anxiety (−0.19, 95% CI −0.344 to −0.047; p = 0.01, d = 0.31) but not on any of the other outcomes. Conclusions PM+ is effective in reducing psychological distress and symptoms of anxiety over a period up to 1 year. Additional support such as booster sessions or additional (trauma-focused) modules may be required to prolong and consolidate benefits gained through PM+ on other mental health and psychosocial outcomes.

Item Type:	Article
Additional Information:	© 2024 The Author(s)
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry H Social Sciences B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited:	01 Nov 2024 11:00
Last Modified:	18 Nov 2024 11:54
URI:	http://eprints.lse.ac.uk/id/eprint/125936

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