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Purgato M, Carswell K, Tedeschi F, et al. Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial. Psychother Psychosom. 2021;90(6):403-414doi: 10.1159/000517504.
Purgato, M., Carswell, K., Tedeschi, F., Acarturk, C., Anttila, M., Au, T., Bajbouj, M., Baumgartner, J., Biondi, M., Churchill, R., Cuijpers, P., Koesters, M., Gastaldon, C., Ilkkursun, Z., Lantta, T., Nosè, M., Ostuzzi, G., Papola, D., Popa, M., Roselli, V., Sijbrandij, M., Tarsitani, L., Turrini, G., Välimäki, M., Walker, L., Wancata, J., Zanini, E., White, R., van Ommeren, M., & Barbui, C. (2021). Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial. Psychotherapy and psychosomatics, 90(6), 403-414. https://doi.org/10.1159/000517504
Purgato, Marianna, et al. "Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial." Psychotherapy and psychosomatics vol. 90,6 (2021): 403-414. doi: https://doi.org/10.1159/000517504
Purgato M, Carswell K, Tedeschi F, Acarturk C, Anttila M, Au T, Bajbouj M, Baumgartner J, Biondi M, Churchill R, Cuijpers P, Koesters M, Gastaldon C, Ilkkursun Z, Lantta T, Nosè M, Ostuzzi G, Papola D, Popa M, Roselli V, Sijbrandij M, Tarsitani L, Turrini G, Välimäki M, Walker L, Wancata J, Zanini E, White R, van Ommeren M, Barbui C. Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial. Psychother Psychosom. 2021;90(6):403-414. doi: 10.1159/000517504. Epub 2021 Jul 20. PMID: 34350902; PMCID: PMC8619740.
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Psychother Psychosom. 2021;90(6):403-414. doi: 10.1159/000517504. Epub 2021 Jul 20.

Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial.

Psychotherapy and psychosomatics

Marianna Purgato, Kenneth Carswell, Federico Tedeschi, Ceren Acarturk, Minna Anttila, Teresa Au, Malek Bajbouj, Josef Baumgartner, Massimo Biondi, Rachel Churchill, Pim Cuijpers, Markus Koesters, Chiara Gastaldon, Zeynep Ilkkursun, Tella Lantta, Michela Nosè, Giovanni Ostuzzi, Davide Papola, Mariana Popa, Valentina Roselli, Marit Sijbrandij, Lorenzo Tarsitani, Giulia Turrini, Maritta Välimäki, Lauren Walker, Johannes Wancata, Elisa Zanini, Ross White, Mark van Ommeren, Corrado Barbui

Affiliations

  1. WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
  2. Cochrane Global Mental Health, University of Verona, Verona, Italy.
  3. Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
  4. Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Turkey.
  5. Department of Nursing Science, University of Turku, Turku, Finland.
  6. Department of Psychiatry, Campus Benjamin Franklin, Charité, Universitätsmedizin, Berlin, Germany.
  7. Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
  8. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
  9. Centre for Review and Dissemination, University of York, York, United Kingdom.
  10. Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  11. WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  12. Department of Psychiatry II, Ulm University, Ulm, Germany.
  13. Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.
  14. Mental Health and Addiction Research Group, University of York, York, United Kingdom.

PMID: 34350902 PMCID: PMC8619740 DOI: 10.1159/000517504

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.

© 2021 The Author(s) Published by S. Karger AG, Basel.

Keywords: Adult; Asylum seekers; Psychological stress; Psychological trauma; Psychological well-being; Randomized controlled trial; Refugees; Self-Help Plus

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