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Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis

Author

Listed:
  • Michela Nosè
  • Francesca Ballette
  • Irene Bighelli
  • Giulia Turrini
  • Marianna Purgato
  • Wietse Tol
  • Stefan Priebe
  • Corrado Barbui

Abstract

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future.

Suggested Citation

  • Michela Nosè & Francesca Ballette & Irene Bighelli & Giulia Turrini & Marianna Purgato & Wietse Tol & Stefan Priebe & Corrado Barbui, 2017. "Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-16, February.
  • Handle: RePEc:plo:pone00:0171030
    DOI: 10.1371/journal.pone.0171030
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    References listed on IDEAS

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    1. Corrado Barbui & Tarun Dua & Mark van Ommeren & M Taghi Yasamy & Alexandra Fleischmann & Nicolas Clark & Graham Thornicroft & Suzanne Hill & Shekhar Saxena, 2010. "Challenges in Developing Evidence-Based Recommendations Using the GRADE Approach: The Case of Mental, Neurological, and Substance Use Disorders," PLOS Medicine, Public Library of Science, vol. 7(8), pages 1-8, August.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Douglas Gruner & Olivia Magwood & Lissa Bair & Liezl Duff & Shiva Adel & Kevin Pottie, 2020. "Understanding Supporting and Hindering Factors in Community-Based Psychotherapy for Refugees: A Realist-Informed Systematic Review," IJERPH, MDPI, vol. 17(13), pages 1-27, June.
    2. Catharina Zehetmair & Valentina Zeyher & Anna Cranz & Beate Ditzen & Sabine C. Herpertz & Rupert Maria Kohl & Christoph Nikendei, 2021. "A Walk-In Clinic for Newly Arrived Mentally Burdened Refugees: The Patient Perspective," IJERPH, MDPI, vol. 18(5), pages 1-16, February.
    3. Rita Doumit & Chant Kazandjian & Lisa K. Militello, 2020. "COPE for Adolescent Syrian Refugees in Lebanon: A Brief Cognitive–Behavioral Skill-Building Intervention to Improve Quality of Life and Promote Positive Mental Health," Clinical Nursing Research, , vol. 29(4), pages 226-234, May.
    4. Henriëtte E. van Heemstra & Willem F. Scholte & Angela Nickerson & Paul A. Boelen, 2021. "Can Circumstances Be Softened? Self-Efficacy, Post-Migratory Stressors, and Mental Health among Refugees," IJERPH, MDPI, vol. 18(4), pages 1-9, February.
    5. Stacey A Shaw & ChenYing Lee & Maryam Ahmadi & Hamid Karim Shor Muluk & Zakaria Mohamed Jibril & Latifa Ahmadi & Lynette Randall & Chongming Yang & Louisa Gilbert, 2023. "A randomized controlled trial testing the feasibility, acceptability, and preliminary effects of a mental health Screening, Brief Intervention, and Referral to Treatment among refugees in Malaysia," International Journal of Social Psychiatry, , vol. 69(8), pages 1898-1908, December.

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