Effectiveness of Self-Help Plus in preventing mental disorders in refugees and asylum seekers in Western Europe: a multinational randomized controlled trial

Marianna Purgatoa, Kenneth Carswell, Federico Tedeschi, Ceren Acarturkd, Minna Anttila, Teresa Au, Malek Bajboujf, Josef Baumgartner, Massimo Biondih, Rachel Churchill, Pim Cuijpers, Markus Koesters, Chiara Gastaldona, Zeynep Ilkkursund, Tella Lantta, Michela Nosè, Giovanni Ostuzzia, Davide Papola, Mariana Popa, Valentina RoselliMarit Sijbrandij, Lorenzo Tarsitani, Giulia Turrini, Maritta Välimäkie, Lauren Walker, Johannes Wancata, Elisa Zanini, Ross White, Mark van Ommeren, Corrado Barbui

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Abstract

Introduction: Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress.

Objective: To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe.

Methods: We conducted a randomized controlled trial in 5 European countries. Refugees and asylum seekers with psychological distress (General Health Questionnaire score ≥3), but without a Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or ICD/10 diagnosis of mental disorder, as assessed with the Mini International Neuropsychiatric Interview (MINI), were randomized to SH+ or enhanced treatment as usual (ETAU). The primary outcome was the frequency of mental disorders with the MINI at 6 months. Secondary outcomes included the frequency of mental disorders at postintervention, self-identified problems, psychological symptoms, and other outcomes.

Results: Four hundred fifty-nine individuals were randomly assigned to SH+ or ETAU. For the primary outcome, we found no difference in the frequency of mental disorders at 6 months (Cramer V = 0.007, p = 0.90, RR = 0.96; 95% CI 0.52–1.78), while the difference significantly favored SH+ at after the intervention (secondary outcome, measured within 2 weeks from the last session; Cramer V = 0.13, p = 0.01, RR = 0.50; 95% CI 0.29–0.87). Conclusions: This is the first randomized indicated prevention study with the aim of preventing the onset of mental disorders in asylum seekers and refugees in Western Europe. As a prevention effect of SH+ was not observed at 6 months, but rather after the intervention only, modalities to maintain its beneficial effect in the long term need to be identified.
Original languageEnglish
JournalPsychotherapy and Psychosomatics
Early online date20 Jul 2021
DOIs
Publication statusEarly online date - 20 Jul 2021

Keywords

  • Adult
  • Asylum seekers
  • Psychological stress
  • Psychological trauma
  • Psychological well-being
  • randomized controlled trial
  • Refugees
  • Self-Help Plus

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