Addressing stress, depression, and anxiety in people exposed to traumatic events in humanitarian settings: A systematic review and meta-analysis of psychosocial interventions

Aims: To evaluate the effectiveness and acceptability of psychosocial interventions compared with control conditions (waiting list, treatment as usual, attention placebo, psychological placebo, or no treatment) in people living in low- resource settings affected by humanitarian crises. Methods: We c...

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Bibliographic Details
Published in:Journal of psychosomatic research 2018-06, Vol.109, p.127-127
Main Authors: Purgato, M., van Ommeren, M., Tol, W., Barbui, C.
Format: Article
Language:English
Subjects:
Anxiety
Clinical trials
Conflict
Crises
Disasters
Dropping out
Health psychology
Humanitarianism
Intervention
Low income groups
Medical research
Mental depression
Mental disorders
Mental health
Mental health services
Meta-analysis
Natural disasters
Organizational effectiveness
Post traumatic stress disorder
Psychological trauma
Psychosocial factors
Psychosocial intervention
Quality of life
Radio
Self help
Stress
Symptoms
Systematic review
Trauma
Traumatic life events
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Summary:Aims: To evaluate the effectiveness and acceptability of psychosocial interventions compared with control conditions (waiting list, treatment as usual, attention placebo, psychological placebo, or no treatment) in people living in low- resource settings affected by humanitarian crises. Methods: We conducted a systematic review and meta-analysis of published and unpublished randomized controlled trials of psychosocial and mental health interventions. We included interventions delivered through any means, including face-to-face meetings, internet, radio, telephone, or self-help booklets between the participant(s) and their helpers. Either individual or group-delivered psychosocial interventions were eligible for inclusion, with no limit to the number of sessions. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Pubmed, PyscArticles, Web of Science, and the main local Low-and Middle-Income Countries (LMICs) databases according to the list of databases relevant to LMIC developed collaboratively by Cochrane and World Health Organization Library, up to September 2017, with no limitations on year or language of publication. Results: Included studies were implemented in various types of humanitarian crises, including armed conflicts and disasters triggered by natural hazards. Psychosocial interventions were more effective than controls in improving post-traumatic stress disorder symptoms (Standardised Mean Difference (SMD) (SMD -1.07, 95% CI -1.34 to -0.79), depression (SMD -0.86, 95% CI -1.06 to -0.67), anxiety (SMD -0.74,95% CI -0.98 to -0.49), and quality of life (SMD -0.73,95% CI -1.22 to -0.25). In subgroup analyses according to the type of traumatic event, we found a significant difference between subgroups in terms of PTSD symptoms (p= 0.004), anxiety (p=0.009), and dropouts (p=0.009). Conclusion: In the near future researchers should conduct further higher quality trials to evaluate the effectiveness of psychosocial interventions over longer periods and including subgroups of the populations. Ideally, trials should be randomised and should adopt culturally appropriate instruments to evaluate outcomes.
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2018.03.122