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Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees:systematic review and meta-analysis

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dc.contributor.author Turrini, G.
dc.contributor.author Purgato, M.
dc.contributor.author Acartürk, Zeynep Ceren
dc.contributor.author Anttila, M.
dc.contributor.author Au, T.
dc.contributor.author Ballette, F.
dc.contributor.author Bird, M.
dc.contributor.author Carswell, K.
dc.contributor.author Churchill, R.
dc.contributor.author Cuijpers, P.
dc.contributor.author Hall, J.
dc.contributor.author Hansen, L.J.
dc.contributor.author Kösters, M.
dc.contributor.author Lantta, T.
dc.contributor.author Nosè, M.
dc.contributor.author Ostuzzi, G.
dc.contributor.author Sijbrandij, M.
dc.contributor.author Tedeschi, F.
dc.contributor.author Valimaki, M.
dc.contributor.author Wancata, J.
dc.contributor.author White, R.
dc.contributor.author Van Ommeren, M.
dc.contributor.author Barbui, C.
dc.date.accessioned 2019-06-11T08:09:30Z
dc.date.available 2019-06-11T08:09:30Z
dc.date.issued 2019
dc.identifier.citation Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., Bird, M., Carswell, K., Churchill, R., Cuijpers, P., Hall, J., Hansen, L.J., Kösters, M., Lantta, T., Nosè, M., Ostuzzi, G., Sijbrandij, M., Tedeschi, F., Valimaki, M., Wancata, J., White, R., Van Ommeren, M., Barbui, C. (2019). Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees:systematic review and meta-analysis. Epidemiology and Psychiatric Sciences, pp. 1-13. en_US
dc.identifier.issn 2045-7960
dc.identifier.uri https://doi.org/10.1017/S2045796019000027
dc.identifier.uri http://hdl.handle.net/11498/56220
dc.description.abstract AimsIn the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.MethodsWe used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.ResultsWe included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = ?irc;'0.71; 95% confidence interval [CI] ?irc;'1.01 to ?irc;'0.41; I 2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = ?irc;'1.02; 95% CI ?irc;'1.52 to ?irc;'0.51; I 2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = ?irc;'1.05; 95% CI ?irc;'1.55 to ?irc;'0.56; I 2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.ConclusionsConsidering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly. Copyright © Cambridge University Press 2019 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.language.iso eng en_US
dc.publisher Cambridge University en_US
dc.rights info:eu-repo/semantics/embargoedAccess en_US
dc.subject Asylums en_US
dc.subject Mental Health en_US
dc.subject Psychosocial Interventions en_US
dc.subject Mülteciler en_US
dc.subject Akıl Sağlığı en_US
dc.subject Psikososyal Müdahaleler en_US
dc.subject.other Article in Press en_US
dc.title Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees:systematic review and meta-analysis en_US
dc.type Other en_US
dc.contributor.authorID 39271 en_US
dc.relation.journal Epidemiology and Psychiatric Sciences en_US

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