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Meta-Analysis
. 2018 Jul 5;7(7):CD011849.
doi: 10.1002/14651858.CD011849.pub2.

Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises

Marianna Purgato  1 , Chiara Gastaldon, Davide Papola, Mark van Ommeren, Corrado Barbui, Wietse A Tol
Affiliations
Meta-Analysis

Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises

Marianna Purgato et al. Cochrane Database Syst Rev. .

Abstract

Background: People living in humanitarian settings in low- and middle-income countries (LMICs) are exposed to a constellation of stressors that make them vulnerable to developing mental disorders. Mental disorders with a higher prevalence in these settings include post-traumatic stress disorder (PTSD) and major depressive, anxiety, somatoform (e.g. medically unexplained physical symptoms (MUPS)), and related disorders. A range of psychological therapies are used to manage symptoms of mental disorders in this population.

Objectives: To compare the effectiveness and acceptability of psychological therapies versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at treating people with mental disorders (PTSD and major depressive, anxiety, somatoform, and related disorders) living in LMICs affected by humanitarian crises.

Search methods: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR), the Cochrane Central Register of Controlled Trials (Wiley), MEDLINE (OVID), Embase (OVID), and PsycINFO (OVID), with results incorporated from searches to 3 February 2016. We also searched the World Health Organization (WHO) trials portal (ICTRP) and ClinicalTrials.gov to identify any unpublished or ongoing studies. We checked the reference lists of relevant studies and reviews.

Selection criteria: All randomised controlled trials (RCTs) comparing psychological therapies versus control conditions (including no treatment, usual care, wait list, attention placebo, and psychological placebo) to treat adults and children with mental disorders living in LMICs affected by humanitarian crises.

Data collection and analysis: We used standard Cochrane procedures for collecting data and evaluating risk of bias. We calculated standardised mean differences for continuous outcomes and risk ratios for dichotomous data, using a random-effects model. We analysed data at endpoint (zero to four weeks after therapy); at medium term (one to four months after therapy); and at long term (six months or longer). GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) was used to assess the quality of evidence for post-traumatic stress disorder (PTSD), depression, anxiety and withdrawal outcomes.

Main results: We included 36 studies (33 RCTs) with a total of 3523 participants. Included studies were conducted in sub-Saharan Africa, the Middle East and North Africa, and Asia. Studies were implemented in response to armed conflicts; disasters triggered by natural hazards; and other types of humanitarian crises. Together, the 33 RCTs compared eight psychological treatments against a control comparator.Four studies included children and adolescents between 5 and 18 years of age. Three studies included mixed populations (two studies included participants between 12 and 25 years of age, and one study included participants between 16 and 65 years of age). Remaining studies included adult populations (18 years of age or older).Included trials compared a psychological therapy versus a control intervention (wait list in most studies; no treatment; treatment as usual). Psychological therapies were categorised mainly as cognitive-behavioural therapy (CBT) in 23 comparisons (including seven comparisons focused on narrative exposure therapy (NET), two focused on common elements treatment approach (CETA), and one focused on brief behavioural activation treatment (BA)); eye movement desensitisation and reprocessing (EMDR) in two comparisons; interpersonal psychotherapy (IPT) in three comparisons; thought field therapy (TFT) in three comparisons; and trauma or general supportive counselling in two comparisons. Although interventions were described under these categories, several psychotherapeutic elements were common to a range of therapies (i.e. psychoeducation, coping skills).In adults, psychological therapies may substantially reduce endpoint PTSD symptoms compared to control conditions (standardised mean difference (SMD) -1.07, 95% confidence interval (CI) -1.34 to -0.79; 1272 participants; 16 studies; low-quality evidence). The effect is smaller at one to four months (SMD -0.49, 95% CI -0.68 to -0.31; 1660 participants; 18 studies) and at six months (SMD -0.37, 95% CI -0.61 to -0.14; 400 participants; five studies). Psychological therapies may also substantially reduce endpoint depression symptoms compared to control conditions (SMD -0.86, 95% CI -1.06 to -0.67; 1254 participants; 14 studies; low-quality evidence). Similar to PTSD symptoms, follow-up data at one to four months showed a smaller effect on depression (SMD -0.42, 95% CI -0.63 to -0.21; 1386 participants; 16 studies). Psychological therapies may moderately reduce anxiety at endpoint (SMD -0.74, 95% CI -0.98 to -0.49; 694 participants; five studies; low-quality evidence) and at one to four months' follow-up after treatment (SMD -0.53, 95% CI -0.66 to -0.39; 969 participants; seven studies). Dropout rates are probably similar between study conditions (19.5% with control versus 19.1% with psychological therapy (RR 0.98 95% CI 0.82 to 1.16; 2930 participants; 23 studies, moderate quality evidence)).In children and adolescents, we found very low quality evidence for lower endpoint PTSD symptoms scores in psychotherapy conditions (CBT) compared to control conditions, although the confidence interval is wide (SMD -1.56, 95% CI -3.13 to 0.01; 130 participants; three studies;). No RCTs provided data on major depression or anxiety in children. The effect on withdrawal was uncertain (RR 1.87 95% CI 0.47 to 7.47; 138 participants; 3 studies, low quality evidence).We did not identify any studies that evaluated psychological treatments on (symptoms of) somatoform disorders or MUPS in LMIC humanitarian settings.

Authors' conclusions: There is low quality evidence that psychological therapies have large or moderate effects in reducing PTSD, depressive, and anxiety symptoms in adults living in humanitarian settings in LMICs. By one to four month and six month follow-up assessments treatment effects were smaller. Fewer trials were focused on children and adolescents and they provide very low quality evidence of a beneficial effect of psychological therapies in reducing PTSD symptoms at endpoint. Confidence in these findings is influenced by the risk of bias in the studies and by substantial levels of heterogeneity. More research evidence is needed, particularly for children and adolescents over longer periods of follow-up.

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Conflict of interest statement

None known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Psychological therapy vs control comparator ‐ PTSD symptoms ‐ adults, Outcome 1 PTSD at endpoint.
1.2
1.2. Analysis
Comparison 1 Psychological therapy vs control comparator ‐ PTSD symptoms ‐ adults, Outcome 2 PTSD at 1 to 4 months.
1.3
1.3. Analysis
Comparison 1 Psychological therapy vs control comparator ‐ PTSD symptoms ‐ adults, Outcome 3 PTSD ≥ 6 months.
2.1
2.1. Analysis
Comparison 2 Psychological therapy vs control comparator ‐ PTSD symptoms ‐ children, Outcome 1 PTSD at endpoint.
2.2
2.2. Analysis
Comparison 2 Psychological therapy vs control comparator ‐ PTSD symptoms ‐ children, Outcome 2 PTSD at 1 to 4 months.
3.1
3.1. Analysis
Comparison 3 Psychological therapy vs control comparator ‐ anxiety symptoms ‐ adults, Outcome 1 Anxiety at endpoint.
3.2
3.2. Analysis
Comparison 3 Psychological therapy vs control comparator ‐ anxiety symptoms ‐ adults, Outcome 2 Anxiety at 1 to 4 months.
3.3
3.3. Analysis
Comparison 3 Psychological therapy vs control comparator ‐ anxiety symptoms ‐ adults, Outcome 3 Anxiety ≥ 6 months.
4.1
4.1. Analysis
Comparison 4 Psychological therapy vs control comparator ‐ depressive symptoms ‐ adults, Outcome 1 Depression at endpoint.
4.2
4.2. Analysis
Comparison 4 Psychological therapy vs control comparator ‐ depressive symptoms ‐ adults, Outcome 2 Depression at 1 to 4 months.
4.3
4.3. Analysis
Comparison 4 Psychological therapy vs control comparator ‐ depressive symptoms ‐ adults, Outcome 3 Depression ≥ 6 months.
5.1
5.1. Analysis
Comparison 5 Psychological therapy vs control comparator ‐ dropout ‐adults, Outcome 1 Dropout.
6.1
6.1. Analysis
Comparison 6 Psychological therapy vs control comparator ‐ dropout ‐ children, Outcome 1 Dropout.
7.1
7.1. Analysis
Comparison 7 Psychological therapy vs control comparator ‐ functional impairment ‐ adults, Outcome 1 Functional impairment at endpoint.
7.2
7.2. Analysis
Comparison 7 Psychological therapy vs control comparator ‐ functional impairment ‐ adults, Outcome 2 Functional impairment at 1 to 4 months.
7.3
7.3. Analysis
Comparison 7 Psychological therapy vs control comparator ‐ functional impairment ‐ adults, Outcome 3 Functional impairment ≥ 6 months.
8.1
8.1. Analysis
Comparison 8 Psychological therapy vs control comparator ‐ quality of life ‐ adults, Outcome 1 Quality of life at endpoint.
9.1
9.1. Analysis
Comparison 9 Psychological therapy vs control comparator ‐ diagnosis of PTSD ‐ adults, Outcome 1 Diagnosis of PTSD.
10.1
10.1. Analysis
Comparison 10 Psychological therapy vs control comparator ‐ diagnosis of PTSD ‐ children, Outcome 1 Diagnosis of PTSD.
11.1
11.1. Analysis
Comparison 11 Psychological therapy vs control comparator ‐ diagnosis of depression ‐ adults, Outcome 1 Diagnosis of depression.
12.1
12.1. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 1 PTSD symptoms at endpoint.
12.2
12.2. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
12.3
12.3. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 3 PTSD symptoms ≥ 6 months.
12.4
12.4. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
12.5
12.5. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
12.6
12.6. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 6 Depressive symptoms at endpoint.
12.7
12.7. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 7 Depressive symptoms at 1 to 4 months.
12.8
12.8. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 8 Depressive symptoms ≥ 6 months.
12.9
12.9. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 9 Dropout.
12.10
12.10. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 10 Functional impairment at endpoint.
12.11
12.11. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 11 Functional impairment at 1 to 4 months.
12.12
12.12. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 12 Quality of life at endpoint.
12.13
12.13. Analysis
Comparison 12 Subgroup analysis: type of traumatic events ‐ adults, Outcome 13 Diagnosis of PTSD.
13.1
13.1. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 1 PTSD symptoms at endpoint.
13.2
13.2. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
13.3
13.3. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 3 PTSD symptoms ≥ 6 months.
13.4
13.4. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
13.5
13.5. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
13.6
13.6. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 6 Depressive symptoms at endpoint.
13.7
13.7. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 7 Depressive symptoms at 1 to 4 months.
13.8
13.8. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 8 Depressive symptoms ≥ 6 months.
13.9
13.9. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 9 Dropout.
13.10
13.10. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 10 Functional impairment at endpoint.
13.11
13.11. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 11 Functional impairment at 1 to 4 months.
13.12
13.12. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 12 Quality of life at endpoint.
13.13
13.13. Analysis
Comparison 13 Subgroup analysis: type of humanitarian crisis ‐ adults, Outcome 13 Diagnosis of PTSD.
14.1
14.1. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 1 PTSD symptoms at endpoint.
14.2
14.2. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
14.3
14.3. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 3 PTSD symptoms ≥6 months.
14.4
14.4. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
14.5
14.5. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
14.6
14.6. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 6 Depressive symptoms at endpoint.
14.7
14.7. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 7 Depressive symptoms at 1 to 4 months.
14.8
14.8. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 8 Depressive symptoms ≥ 6 months.
14.9
14.9. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 9 Dropout.
14.10
14.10. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 10 Functional impairment at endpoint.
14.11
14.11. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 11 Functional impairment at 1 to 4 months.
14.12
14.12. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 12 Quality of life at endpoint.
14.13
14.13. Analysis
Comparison 14 Subgroup analysis: type of interventionists ‐ adults, Outcome 13 Diagnosis of PTSD.
15.1
15.1. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 1 PTSD symptoms at endpoint.
15.2
15.2. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
15.3
15.3. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 3 PTSD symptoms ≥ 6 months.
15.4
15.4. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
15.5
15.5. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
15.6
15.6. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 6 Anxiety symptoms ≥ 6 months.
15.7
15.7. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 7 Depressive symptoms at endpoint.
15.8
15.8. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 8 Depressive symptoms at 1 to 4 months.
15.9
15.9. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 9 Depressive symptoms ≥ 6 months.
15.10
15.10. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 10 Dropout.
15.11
15.11. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 11 Functional impairment at endpoint.
15.12
15.12. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 12 Functional impairment at 1 to 4 months.
15.13
15.13. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 13 Functional impairment ≥ 6 months.
15.14
15.14. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 14 Quality of life at endpoint.
15.15
15.15. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 15 Diagnosis of PTSD.
15.16
15.16. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 16 Diagnosis of depression.
15.17
15.17. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 17 Coping at endpoint.
15.18
15.18. Analysis
Comparison 15 Subgroup analysis: type of control ‐ adults, Outcome 18 Coping at 1 to 4 months.
16.1
16.1. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 1 PTSD symptoms at endpoint.
16.2
16.2. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
16.3
16.3. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 3 PTSD symptoms ≥ 6 months.
16.4
16.4. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
16.5
16.5. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
16.6
16.6. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 6 Depressive symptoms at endpoint.
16.7
16.7. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 7 Depressive symptoms at 1 to 4 months.
16.8
16.8. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 8 Depressive symptoms ≥ 6 months.
16.9
16.9. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 9 Dropout.
16.10
16.10. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 10 Functional impairment at endpoint.
16.11
16.11. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 11 Functional impairment at 1 to 4 months.
16.12
16.12. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 12 Quality of life at endpoint.
16.13
16.13. Analysis
Comparison 16 Subgroup analysis: phase of humanitarian crisis ‐ adults, Outcome 13 Diagnosis of PTSD.
17.1
17.1. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 1 PTSD symptoms at endpoint.
17.2
17.2. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
17.3
17.3. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 3 PTSD symptoms ≥ 6 months.
17.4
17.4. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 4 Anxiety symptoms at endpoint.
17.5
17.5. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 5 Anxiety symptoms at 1 to 4 months.
17.6
17.6. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 6 Depressive symptoms ≥ 6 months.
17.7
17.7. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 7 Depressive symptoms at endpoint.
17.8
17.8. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 8 Depressive symptoms at 1 to 4 months.
17.9
17.9. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 9 Dropout.
17.10
17.10. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 10 Functional impairment at endpoint.
17.11
17.11. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 11 Functional impairment at 1 to 4 months.
17.12
17.12. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 12 Quality of life at endpoint.
17.13
17.13. Analysis
Comparison 17 Sensitivity analysis: incomplete outcome data ‐ adults, Outcome 13 Diagnosis of PTSD.
18.1
18.1. Analysis
Comparison 18 Sensitivity analysis: selective reporting ‐ adults, Outcome 1 PTSD symptoms at endpoint.
18.2
18.2. Analysis
Comparison 18 Sensitivity analysis: selective reporting ‐ adults, Outcome 2 PTSD symptoms at 1 to 4 months.
18.3
18.3. Analysis
Comparison 18 Sensitivity analysis: selective reporting ‐ adults, Outcome 3 Dropout.
18.4
18.4. Analysis
Comparison 18 Sensitivity analysis: selective reporting ‐ adults, Outcome 4 Functional impairment at endpoint.
18.5
18.5. Analysis
Comparison 18 Sensitivity analysis: selective reporting ‐ adults, Outcome 5 Quality of life at endpoint.
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References

References to studies included in this review

Acarturk 2015 {published data only}
    1. Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Cuijpers P, et al. EMDR for Syrian refugees with post‐traumatic stress disorder symptoms: results of a pilot randomized controlled trial. European Journal of Psychotraumatology 2015;6:27414. - PMC - PubMed
Acaturk 2016 {published data only}
    1. Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Gulen B, et al. The efficacy of eye movement desensitization and reprocessing for post‐traumatic stress disorder and depression among Syrian refugees: results of a randomized controlled trial. Psychological Medicine 2016;46:2583–93. - PubMed
Ahmadizadeh 2013 {published data only}
    1. Ahmadizadeh M, Ahmadi K, Anisi J, Ahmadi AB. Assessment of cognitive behavioral therapy on quality of life of patients with chronic war‐related post‐traumatic stress disorder. Indian Journal of Psychological Medicine 2013;35(4):341‐5. - PMC - PubMed
Azad Marzabadi 2014 {published data only}
    1. Azad Marzabadi E, Hashemi Zadeh SM. The effectiveness of mindfulness training in improving the quality of life of the war victims with post traumatic stress disorder (PTSD). Iran Journal of Psychiatry 2014;9(4):228‐36. - PMC - PubMed
Basoglu 2005 {published data only}
    1. Başoğlu M, Salcioğlu E, Livanou M, Kalender D, Acar G. Single‐session behavioral treatment of earthquake‐related post‐traumatic stress disorder: a randomized waiting list controlled trial. Journal of Traumatic Stress 2005;18(1):1‐11. - PubMed
Basoglu 2007 {published data only}
    1. Başoglu M, Salcioglu E, Livanou M. A randomized controlled study of single‐session behavioural treatment of earthquake‐related post‐traumatic stress disorder using an earthquake simulator. Psychological Medicine 2007;37(2):203‐13. - PubMed
Bass 2016 {published data only}
    1. Bass J, Murray SM, Mohammed TA, Bunn M, Gorman W, Ahmed AM, et al. A randomized controlled trial of a trauma‐informed support, skills, and psychoeducation intervention for survivors of torture and related trauma in Kurdistan, Northern Iraq. Global Health Science and Practice 2016;4(3):452‐66. - PMC - PubMed
Bolton 2007 {published data only}
    1. Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, et al. Interventions for depression symptoms among adolescent survivors of war and displacement in Northern Uganda. A randomized controlled trial. Journal of the American Medical Association 2007;298(5):519‐27. - PubMed
Bolton 2014a {published data only}
    1. Bolton P. Controlled trial of mental health interventions for torture survivors in Kurdistan. clinicaltrialsgov/ct2/show/NCT00925262.
    1. Bolton P, Bass JK, Zangana GA, Kamal T, Murray SM, Kaysen D, et al. A randomized controlled trial of mental health interventions for survivors of systematic violence in Kurdistan, Northern Iraq. BMC Psychiatry 2014;14:360. - PMC - PubMed
Bolton 2014b {published data only}
    1. Bolton P, Lee C, Haroz EE, Murray L, Dorsey S, Robinson C, et al. A transdiagnostic community‐based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLoS Medicine 2014; Vol. 11, issue 11:e1001757. - PMC - PubMed
Bryant 2011 {published data only}
    1. Bryant RA, Ekasawin S, Chakrabhand S, Suwanmitri S, Duangchun O, Chantaluckwong T. A randomized controlled effectiveness trial of cognitive behavior therapy for post‐traumatic stress disorder in terrorist‐affected people in Thailand. World Psychiatry 2011;10(3):205‐9. - PMC - PubMed
Chen 2014 {published data only}
    1. Chen Y, Shen WW, Gao K, Lam CS, Chang WC, Deng H. Effectiveness RCT of a CBT intervention for youths who lost parents in the Sichuan, China, earthquake. Psychiatric Services 2014;65(2):259‐62. - PubMed
Connolly 2011 {published data only}
    1. Connolly S, Sakai C. Brief trauma intervention with Rwandan genocide‐survivors using thought field therapy. International Journal of Emergency in Mental Health 2011;13(3):161‐72. - PubMed
Connolly 2013 {published data only}
    1. Connolly SM, Roe‐Sepowitz D, Sakai C, Edwards J. Utilizing community resources to treat PTSD: a randomized controlled study using thought field therapy. Journal of Traumatic Stress 2013;3:24‐32.
Ertl 2011 {published data only}
    1. Ertl V, Pfeiffer A, Schauer E, Elbert T, Neuner F. Community‐implemented trauma therapy for former child soldiers in Northern Uganda: a randomized controlled trial. Journal of the American Medical Association 2011;306(5):503‐12. - PubMed
Hermenau 2013 {published data only}
    1. Hermenau K, Hecker T, Schaal S, Maedl A, Elbert T. Addressing post‐traumatic stress and aggression by means of narrative exposure: a randomized controlled trial with ex‐combatants in the eastern DRC. Journal of Aggression Maltreatment & Trauma 2013;22:916‐34.
Igreja 2004 {published data only}
    1. Igreja V, Kleijn WC, Schreuder BJ, Dijk JA, Verschuur M. Testimony method to ameliorate post‐traumatic stress symptoms. Community‐based intervention study with Mozambican civil war survivors. British Journal of Psychiatry 2004;184:251‐7. - PubMed
Jacob 2014 {published data only}
    1. Jacob N, Neuner F, Maedl A, Schaal S, Elbert T. Dissemination of psychotherapy for trauma spectrum disorders in postconflict settings: a randomized controlled trial in Rwanda. Psychotherapy Psychosomatics 2014;83(6):354‐63. - PubMed
Jiang 2014 {published data only}
    1. Jiang RF, Tong HQ, Delucchi KL, Neylan TC, Shi Q, Meffert SM. Interpersonal psychotherapy versus treatment as usual for PTSD and depression among Sichuan earthquake survivors: a randomized clinical trial. Conflict and Health 2014;8:14. - PMC - PubMed
Knaevelsrud 2015 {published data only}
    1. Knaevelsrud C, Brand J, Lange A, Ruwaard J, Wagner B. Web‐based psychotherapy for post‐traumatic stress disorder in war‐traumatized Arab patients: randomized controlled trial. Journal of Medical Internet Research 2015;17(3):e71. - PMC - PubMed
    1. Wagner B, Brand J, Schulz W, Knaevelsrud C. Online working alliance predicts treatment outcome for post‐traumatic stress symptoms in Arab war‐traumatized patients. Depression and Anxiety 2012;29:646‐51. - PubMed
McMullen 2013 {published data only}
    1. McMullen J. Randomized control trial of group intervention with former war‐affected boys in the Democratic Republic of Congo. clinicaltrialsgov/show/NCT01494831.
    1. McMullen J, O’Callaghan P, Shannon C, Black A, Eakin J. Group trauma‐focused cognitive‐behavioural therapy with former child soldiers and other war‐affected boys in the DR Congo: a randomised controlled trial. Journal of Child Psychology and Psychiatry 2013;54(11):1231‐41. - PubMed
Meffert 2014 {published data only}
    1. Meffert SM, Abdo AO, Alla OAA, Elmakki YOM, Metzler TJ, Marmar CR. A pilot randomized controlled trial of interpersonal psychotherapy for Sudanese refugees in Cairo, Egypt. Psychological Trauma: Theory Research Practice and Policy 2014;6(3):240‐9.
Neuner 2008a {published data only}
    1. Neuner F, Onyut PL, Ertl V, Odenwald M, Schauer E, Elbert T. Treatment of post‐traumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial. Journal of Consulting and Clinical Psychology 2008;76(4):686‐94. - PubMed
Neuner 2008b {published data only}
    1. Neuner F, Onyut PL, Ertl V, Odenwald M, Schauer E, Elbert T. Treatment of post‐traumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial. Journal of Consulting and Clinical Psychology 2008;76(4):686‐94. - PubMed
O' Callaghan 2013 {published data only}
    1. O'Callaghan P. Is trauma‐focused cognitive behavioral therapy effective in reducing post‐traumatic stress and psychosocial distress among sexually exploited, war‐affected girls in the Democratic Republic of Congo. clinicaltrialsgov [wwwclinicaltrialsgov] NCT01483261.
    1. O'Callaghan P, McMullen J, Shannon C, Rafferty H, Black A. A randomized controlled trial of trauma‐focused cognitive behavioral therapy for sexually exploited, war‐affected Congolese girls. Journal of American Academy of Child & Adolescent Psychiatry 2013;52(4):359‐69. - PubMed
Pityaratstian 2015 {published data only}
    1. Pityaratstian N, Piyasil V, Ketumarn P, Sitdhiraksa N Ularntinon S, Pariwatcharakul P. Randomized controlled trial of group cognitive behavioural therapy for post‐traumatic stress disorder in children and adolescents exposed to tsunami in Thailand. Behavioural and Cognitive Psychotherapy 2015;43:549‐61. - PubMed
Puvimanasinghe 2016 {published data only}
    1. Puvimanasinghe TS, Price IR. Healing through giving testimony: an empirical study with Sri Lankan torture survivors. Transcultural Psychiatry 2016;53(5):531‐50. - PubMed
Rahman 2016a {published data only}
    1. Rahman A, Hamdani SU, Awan NR, Bryant RA, Dawson KS, Khan MF, et al. Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict‐affected area of Pakistan: a randomized clinical trial. Journal of the American Medical Association 2016;316(24):doi:10.1001/jama.2016.17165. - PubMed
Rahman 2016b {published data only}
    1. Rahman A, Riaz R, Dawson KS, Hamdani SU, Chiumento A, Sijbrandij M, et al. Problem Management Plus (PM1): pilot trial of a WHO transdiagnostic psychological intervention in conflict‐affected Pakistan. World Psychiatry 2016;15(2):182‐3. - PMC - PubMed
Wang 2013a {published data only}
    1. Wang Z, Wang J, Maercker A. Chinese My Trauma recovery, a web‐based intervention for traumatized persons in two parallel samples: randomized controlled trial. Journal of Medical Internet Research 2013;15(9):e213. - PMC - PubMed
Wang 2013b {published data only}
    1. Wang Z, Wang J, Maercker A. Chinese My Trauma recovery, a web‐based intervention for traumatized persons in two parallel samples: randomized controlled trial. Journal of Medical Internet Research 2013;15(9):e213. - PMC - PubMed
Wang 2016 {published data only}
    1. Wang SJ, Bytyci A, Izeti S, Kallaba M, Rushiti F, Montgomery E, et al. A novel bio‐psycho‐social approach for rehabilitation of traumatized victims of torture and war in the post‐conflict context: a pilot randomized controlled trial in Kosovo. Conflict and Health 2016;10(34):1‐17. - PMC - PubMed
Weiss 2015a {published data only}
    1. Weiss WM, Murray LK, Zangana GAS, Mahmooth Z, Kaysen D, Dorsey S, et al. Community‐based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry 2015;15:249. - PMC - PubMed
Weiss 2015b {published data only}
    1. Weiss WM, Murray LK, Zangana GAS, Mahmooth Z, Kaysen D, Dorsey S, et al. Community‐based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry 2015;15:249. - PMC - PubMed
Zang 2013 {published data only}
    1. Zang Y, Hunt N, Cox T. A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake. BMC Psychiatry 2013;13:41. - PMC - PubMed
Zang 2014 {published data only}
    1. Zang Y, Hunt N, Cox T. Adapting narrative exposure therapy for Chinese earthquake survivors: a pilot randomised controlled feasibility study. BMC Psychiatry 2014;14:262. - PMC - PubMed

References to studies excluded from this review

Adenauer 2011 {published data only}
    1. Adenauer H, Catani C, Gola H, Keil J, Ruf M, Schauer M, et al. Narrative exposure therapy for PTSD increases top‐down processing of aversive stimuli‐evidence from a randomized controlled treatment trial. BMC Neuroscience 2011;12:127. - PMC - PubMed
Ager 2011 {published data only}
    1. Ager A, Akesson B, Stark L, Flouri E, Okot B, McCollister F, et al. The impact of the school‐based Psychosocial Structured Activities (PSSA) program on conflict‐affected children in Northern Uganda. Journal of Child Psychology and Psychiatry 2011;52(11):1124‐33. - PubMed
Akhtar 1994 {published data only}
    1. Akhtar P. Project report: therapeutic effects of music on torture survivors and refugees. Torture 1994;4:121‐3.
Ayoughi 2012 {published data only}
    1. Ayoughi S, Missmahl I, Weierstall R, Elbert T. Provision of mental health services in resource‐poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar‐e‐Sharif). BMC Psychiatry 2012;12:14. - PMC - PubMed
Barron 2013 {published data only}
    1. Barron IG, Abdallah G, Smith P. Randomized control trial of a CBT trauma recovery program in Palestinian schools. Journal of Loss & Trauma 2013;18:306‐21.
Başoğlu 2003 {published data only}
    1. Başoğlu M, Livanou M, Salcioğlu E, Kalender D. A brief behavioural treatment of chronic post‐traumatic stress disorder in earthquake survivors: results from an open clinical trial. Psychological Medicine 2003;33(4):647‐54. - PubMed
Bass 2012 {published data only}
    1. Bass J, Poudyal B, Tol W, Murray L, Nadison M, Bolton P. A controlled trial of problem‐solving counseling for war‐affected adults in Aceh, Indonesia. Social Psychiatry and Psychiatric Epidemiology 2012;47(2):279‐91. - PubMed
Bass 2013 {published data only}
    1. Bass JK, Annan J, McIvor Murray S, Kaysen D, Griffiths S, Cetinoglu T, et al. Controlled trial of psychotherapy for Congolese survivors of sexual violence. New England Journal of Medicine 2013;368(23):2182‐91. - PubMed
Beck 2009 {published data only}
    1. Beck J, Coffey SF, Foy DW, Keane TM, Blanchard EB. Group cognitive behavior therapy for chronic post‐traumatic stress disorder: an initial randomized pilot study. Behavioral Therapy 2009;40:82‐92. - PubMed
Becker 2009 {published data only}
    1. Becker SM. Psychosocial care for women survivors of the tsunami disaster in India. American Journal of Public Health 2009;99(4):654‐8. - PMC - PubMed
Berger 2015 {published data only}
    1. Berger R, Gelkopf M, Heineberg Y, Zimbardo P. A school‐based intervention for reducing post‐traumatic symptomatology and intolerance during political violence. Journal of Educational Psychology 2015;108(6):1‐10.
Betancourt 2014 {published data only}
    1. Betancourt TS, McBain R, Newham EA, Akinsulure‐Smith A, Brennan R, Weisz JR, Hansen NB. A behavioural intervention for war‐affected youth in Sierra Leone: a randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry 53;12:1288‐97. - PMC - PubMed
Bichescu 2007 {published data only}
    1. Bichescu D, Neuner F, Schauer M, Elbert T. Narrative exposure therapy for political imprisonment‐related chronic post‐traumatic stress disorder and depression. Behavioral Research Therapy 2007;45(9):2212‐20. - PubMed
Bolton 2003 {published data only}
    1. Bolton P, Bass J, Neugebauer R, Verdeli H, Clougherty KF, Wickramaratne P, et al. Group interpersonal psychotherapy for depression in rural Uganda: a randomized controlled trial. JAMA 2003;289(23):3117‐24. - PubMed
Bolton 2009 {published data only}
    1. Bolton P, Murray L, Bass J. School based intervention improves PTSD symptoms in children affected by political violence. Evidence Based Mental Health 2009;12(2):47. - PubMed
Chibanda 2016 {published data only}
    1. Chibanda D, Weiss H, Verhey R, Simms V, Munjoma R, Rusakaniko S, et al. Effect of a primary care‐based psychological intervention on symptoms of common mental disorders in Zimbabwe. A randomized clinical trial. Journal of the American Medical Association 2016;316(24):2618‐26. - PubMed
Gordon 2008 {published data only}
    1. Gordon J, Staples J, Blyta A, Bytyqi M, Wilson A. Treatment of post‐traumatic stress disorder in postwar Kosovar adolescents using mind‐body skills groups: a randomized controlled trial. Journal of Clinical Psychiatry 2008;69:1469‐76. - PubMed
Jordans 2010 {published data only}
    1. Jordans MJ, Komproe IH, Tol WA, Kohrt BA, Luitel NP, Macy RD, et al. Evaluation of a classroom‐based psychosocial intervention in conflict‐affected nepal: a cluster randomized controlled trial. Journal of Child Psychology and Psychiatry 2010;51(7):818‐26. - PubMed
Mughal 2015 {published data only}
    1. Mughal U, Carrasco D, Brown R, Ayers S. Rehabilitating civilian victims of war through psychosocial intervention in Sierra Leone. Journal of Applied Social Psychology 2015;45:593‐601.
Murray 2015 {published data only}
    1. Murray LK, Skavenski S, Kane JC, Mayeya J, Dorsey S, Cohen JA, et al. Effectiveness of trauma‐focused cognitive behavioral therapy among trauma‐affected children in Lusaka, Zambia; a randomized clinical trial. JAMA Pedriatic 2015;169(8):761‐9. - PMC - PubMed
Newnham 2015 {published data only}
    1. Newnham EA, McBain RK, Hann K, Akinsulure‐Smith AM, Weisz J, Lilienthal GM, et al. The Youth Readiness Intervention for war‐affected youth. Journal of Adolescent Health 2015;56(6):606‐11. - PubMed
O'Callaghan 2014 {published data only}
    1. O'Callaghan P, Branham L, Shannon C, Betancourt T, Dempster M, McMullen J. A pilot study of a family focused, psychosocial intervention with war‐exposed youth at risk of attack and abduction in north‐eastern Democratic Republic of Congo. Child Abuse & Neglect 2014;38:1197‐207. - PubMed
Pokharial 2012 {published data only}
    1. Pokhariyal GP, Rono R, Munywoki S. Analysis of treatment methods for victims of torture in Kenya and East Africa region. Traumatology 2012;19(2):107‐17.
Punamaki 2014 {published data only}
    1. Diab M, Peltonen K, Qouta S, Palosaari E, Punamaki RA. Effectiveness of psychosocial intervention enhancing resilience among war‐affected children and the moderating role of family factors. Child Abuse & Neglect 2015;40:24‐35. - PubMed
    1. Diab M, Punamaki RL, Palosaari E, Qouta S. Can psychosocial intervention improve peer and sibling relations among war‐affected children? Impact and mediating analyses in a randomized controlled trial. Social Development 2013;23(2):215‐31.
    1. Punamaki RL, Peltonen K, Diab M, Qouta S. Psychosocial interventions and emotion regulation among war‐affected children: randomized controlled trial effects. Traumatology 2014;20(4):241‐52.
Richards 2014 {published data only}
    1. Richards J, Foster C, Townsend N, Bauman A. Physical fitness and mental health impact of a sport‐for‐development intervention in a post‐conflict setting: randomized controlled trial nested within an observational study of adolescents in Gulu, Uganda. BMC Public Health 2014;18(14):619. - PMC - PubMed
Robson 2016 {published data only}
    1. Robson RH, Robson PM, Ludwig R, Mitabu C, Philips C. Effectiveness of thought field therapy provided by newly instructed community workers to a traumatized population in Uganda: a randomized trial. Current Research in Psychology 2016;7(1):1‐11.
Tiwari 2010 {published data only}
    1. Tiwari A, Fong DY, Yuen KH, Yuk H, Pang P, Humphreys J, et al. Effect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: a randomized controlled trial. Journal of the American Medical Association 2010;304(5):536‐43. - PubMed
Tol 2008 {published data only}
    1. Tol WA, Komproe IH, Susanty D, Jordans MJ, Macy RD, Jong JT. School‐based mental health intervention for children affected by political violence in Indonesia: a cluster randomized trial. Journal of the American Medical Association 2008;300(6):544. - PubMed
Tol 2012 {published data only}
    1. Tol WA, Komproe IH, Jordans MJ, Vallipuram A, Sipsma H, Macy RD, et al. Outcomes and moderators of a preventive school‐based mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial. World Psychiatry 2012;11(2):114‐22. - PMC - PubMed
Tol 2014 {published data only}
    1. Tol WA, Komproe IH, Jordans MJ, Ndayisaba A, Ntamutumba P, Sipsma H, et al. School based mental health intervention for children in war‐affected Burundi: a cluster randomized trial. BMC Medicine 2014;12(56):1‐12. - PMC - PubMed
Unterhitzenberger 2014 {published data only}
    1. Unterhitzenberger J, Rosner R. Lessons from writing sessions: a school‐based randomized trial with adolescent orphans in Rwanda. European Journal of Psychotraumatology 2014;5:1‐10. - PMC - PubMed

References to studies awaiting assessment

Abbasnehzad 2007 {published data only}
    1. Abbasnezhad M, Nemat Elah Zadeh Mahani K, Zamyad A. Efficacy of "eye movement desensitization and reprocessing" in reducing anxiety and unpleasant feelings due to earthquake experience. Psychological Research 2007;9(3‐4):104‐17.
Barron 2016 {published data only}
    1. Barron I, Abdallah G, Heltne U. Randomized control trial of teaching recovery techniques in rural occupied Palestine: effect on adolescent dissociation. Journal of Aggression Maltreatment and Trauma 2016;25(9):995‐73.
Dawson 2016 {published data only}
    1. Dawson KS, Schafer A, Anjuri D, Ndogoni L, Musyoki C, Sijbrandij M, et al. Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender‐based violence in Nairobi. BMC Psychiatry 2016;16. - PMC - PubMed
Esala 2017 {published data only}
    1. Esala JJ, Taing S. Testimony therapy with ritual: a pilot randomized controlled trial. Journal of Traumatic Stress 2017;30(1):94‐8. - PubMed
Khan 2017 {published data only}
    1. Khan MN, Hamdani SU, Chiumento A, Dawson K, Bryant RA, Sijbrandij M, et al. Evaluating feasibility and acceptability of a group WHO trans‐diagnostic intervention for women with common mental disorders in rural Pakistan: a cluster randomised controlled feasibility trial. Epidemiology and Psychiatric Sciences 2017:1‐11. - PMC - PubMed
Mahmoudi‐Gharaei 2006 {published data only}
    1. Mahmoudi‐Gharaei J, Mohammadi M, Bina MYM, Fakour Y. Supportive and cognitive behavioural group interventions on Bam earthquake related PTSD symptoms in adolescents Persian. Tehran University Medical Journal 2006;64:57‐67.
NCT02598024 {unpublished data only}
    1. NCT02598024. Treating Earthquake in Nepal Trauma (TENT) Trial 2016. ClinicalTrialsgov/show/NCT02598024 2016.
Reger 2016 {published data only}
    1. Reger GM, Koenen‐Woods P, Zetocha K, Smolenski DJ, Holloway KM, Rothbaum BO, et al. Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment‐related posttraumatic stress disorder (PTSD). Journal of Consulting and Clinical Psychology 2016;84(11):946‐59. - PubMed
Steinert 2017 {published data only}
    1. Steinert C, Bumke P, Hollekamp R, Larisch A, Leichsenring F, et al. Treating post‐traumatic stress disorder by resource activation in Cambodia. World Psychiatry 2016;15(2):183‐5. - PMC - PubMed
    1. Steinert C, Bumke PJ, Hollekamp RL, Larisch A, Leichsenring F, Matthes H, et al. Resource activation for treating post‐traumatic stress disorder, co‐morbid symptoms and impaired functioning: a randomized controlled trial in Cambodia. Psychological Medicine 2017;47(3):553‐64. - PubMed
Weinstein 2016 {published data only}
    1. Weinstein N, Khabbaz F, Legate N. Enhancing need satisfaction to reduce psychological distress in Syrian refugees. Journal of Consulting and Clinical Psychology 2016;84(7):645‐50. - PubMed

References to ongoing studies

ISRCTN65771265 {published data only}
    1. Greene C, Tol W. Nguvu: Evaluating an integrated approach to reduce intimate partner violence and psychological distress in refugees in Tanzania. apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN65771265.
NCT03012451 {unpublished data only}
    1. Panter‐Brick C. A psychosocial program impact evaluation in Jordan. clinicaltrials.gov/ct2/show/NCT03012451?term=humanitarian+OR+low+and+mid....
NCT031090028 {published data only}
    1. NCT03109028. Mental health in refugees and asylum seekers. ClinicalTrialsgov/show/NCT03109028.

Additional references

Abbass 2014
    1. Abbass AA, Kisely SR, Town JM, Leichsenring F, Driessen E, Maat S, et al. Short‐term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews 2014, Issue 7. [DOI: 10.1002/14651858.CD004687.pub4] - DOI - PMC - PubMed
Allen 2010
    1. Allen LA, Woolfolk RL. Cognitive behavioral therapy for somatoform disorders. Psychiatric Clinics of North America 2010;33(3):579‐93. - PubMed
Altman 1996
    1. Altman DG, Bland JM. Detecting skewness from summary information. British Medical Journal 1996;313(7066):1200. - PMC - PubMed
APA 1980
    1. American Psychiatric Association. iagnostic and Statistical Manual of Mental Disorders (DSM‐III). Diagnostic and Statistical Manual of Mental Disorders (DSM‐III). 3rd Edition. Washington, DC: American Psychiatric Association, 1980.
APA 1987
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐III‐R). 3rd Edition. Washington, DC: American Psychiatric Association, 1987.
APA 1994
    1. American Psychiatric Association. .. Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV). 4th Edition. Washington, DC: American Psychiatric Association, 1994.
APA 2000
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV‐TR). 4th Edition. Washington, DC: American Psychiatric Association, 2000.
APA 2013
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐V). 5th Edition. Washington, DC: American Psychiatric Association, 2103.
Barbui 2011
    1. Barbui C, Cipriani A. Cluster randomised trials. Epidemiology and Psychiatric Sciences 2011;20(4):307‐9. - PubMed
Barbui 2017
    1. Barbui C, Purgato M, Churchill R, Adams C, Amato L, Macdonald G, et al. Cochrane for global mental health. Lancet Psychiatry 2017;4:e6. - PubMed
Beck 1961
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561‐71. - PubMed
Beck 1979
    1. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy for Depression. New York: Guilford Press, 1979.
Birleson 1987
    1. Birleson P, Hudson I, Grey‐Buchanan D, Wolff S. Clinical evaluation of a self‐rating scale for depressive disorder in childhood (Depression Self‐Rating Scale). Journal of Child Psychology and Psychiatry 1987;28:43‐60. - PubMed
Birmaher 1997
    1. Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. Journal of the American Academy of Child & Adolescent 1997;36(4):545‐53. - PubMed
Bisson 2013
    1. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews 2013, Issue 12. [DOI: 10.1002/14651858.CD003388.pub4] - DOI - PMC - PubMed
Blake 1995
    1. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, et al. The development of a clinician‐administered PTSD scale. Journal of Traumatic Stress 1995;8(1):75‐90. - PubMed
Brom 1989
    1. Brom D, Kleber RJ, Defares PB. Brief psychotherapy for post‐traumatic stress disorders. Journal of Consulting and Clinical Psychology 1989;57(5):607‐12. - PubMed
Callahan 2000
    1. Callahan RJ, Callahan J. Stop the nightmares of trauma. Stop the Nightmares of Trauma. Chapel Hill, NC: Professional Press, 2000.
Charlson 2016
    1. Charlson FJ, Flaxman A, Ferrari AJ, Vos T, Steel Z, Whiteford HA. Post‐traumatic stress disorder and major depression in conflict‐affected populations: an epidemiological model and predictor analysis. Global Mental Health 2016;3:e4. [DOI: 10.1017/gmh.2015.26] - DOI - PMC - PubMed
Cohen 1992
    1. Cohen J. A power primer. Psychological Bulletin 1992;112(1):155‐9. - PubMed
Colliard 2014
    1. Colliard C, Bizouerne C, Corna F, ACF Mental Health and Care Practices Team. The Psychological Impact of Humanitarian Crises: A Better Understanding for Better Interventions. Paris: Action contre la Faim – France, 2014.
Cuijpers 2009
    1. Cuijpers P, Straten A, Warmerdam L, Andersson G. Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta‐analysis. Depression and Anxiety 2009;26(3):279‐88. - PubMed
Dennis 2007
    1. Dennis CL, Hodnett E. Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD006116.pub2] - DOI - PubMed
DePaulo 2014
    1. DePaulo JR, Bienvenu OJ (editors). The Johns Hopkins Psychiatry Guide. In: DePaulo JR, Bienvenu OJ editor(s). The Johns Hopkins Psychiatry Guide. Baltimore: Johns Hopkins, 2014.
der Simonian 1986
    1. Simonian R, Laird N. Meta‐analysis in clinical trials. Controlled Clinical Trials 1986;7(3):177‐88. - PubMed
Fergusson 2005
    1. Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood. Psychological Medicine 2005;35(7):983‐93. - PubMed
Forbes 2010
    1. Forbes D, Creamer M, Bisson JI, Cohen JA, Crow BE, Foa EB, et al. A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress 2010;23(5):537‐52. - PubMed
Furukawa 2002
    1. Furukawa TA, Guyatt GH, Griffith LE. Can we individualize the 'number needed to treat'? An empirical study of summary effect measures in meta‐analyses. International Journal of Epidemiology 2002;31(1):72‐6. - PubMed
Gierk 2014
    1. Gierk B, Kohlmann S, Kroenke K, Spangenberg L, Zenger M, Brähler E, et al. The Somatic Symptom Scale–8 (SSS‐8): a brief measure of somatic symptom burden. JAMA Internal Medicine 2014;174(3):399‐407. - PubMed
Gillies 2016
    1. Gillies D, Maiocchi L, Bhandari AP, Taylor F, Gray C, O'Brien L. Psychological therapies for the treatment of post‐traumatic stress disorder in children and adolescents. Cochrane Database of Systematic Reviews 2016, Issue 10. [DOI: 10.1002/14651858.CD006726.pub2] - DOI - PMC - PubMed
Gloaguen 1998
    1. Gloaguen V, Cottraux J, Cucherat M, Blackburn IM. A meta‐analysis of the effects of cognitive therapy in depressed patients. Journal of Affective Disorders 1998;49:59‐72. - PubMed
Guha‐Sapir 2014
    1. Guha‐Sapir D, Hoyois P, Below R. Annual Disaster Statistical Review 2013: the numbers and trends. reliefweb.int/report/world/annual‐disaster‐statistical‐review‐2013‐numbe....
Hamilton 1960
    1. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56‐62. - PMC - PubMed
Haroz 2016
    1. Haroz EE, Ritchey M, Bass JK, Kohrt BA, Augustinavicius J, Michalopoulos L, et al. How is depression experienced around the world? A systematic review of qualitative literature. Social Science and Medicine 2016;16:1‐12. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Chichester: John Wiley & Sons, Ltd, 2011.
Hoskins 2015
    1. Hoskins M, Pearce J, Bethell A, Dankova L, Barbui C, Tol WA, et al. Pharmacotherapy for post‐traumatic stress disorder: systematic review and meta‐analysis. British Journal of Psychiatry 2015;206(2):93‐100. - PubMed
IASC 2007
    1. Inter‐Agency Standing Committee (IASC). IASC guidelines on mental health and psychosocial support in emergency settings. www.who.int/hac/network/interagency/news/iasc_guidelines_mental_health_p... 2007. - PubMed
Jakupcak 2010
    1. Jakupcak M, Wagner A, Paulson A, Varra A, McFall M. Behavioral activation as a primary care‐based treatment for PTSD and depression among returning veterans. Journal of Traumatic Stress 2010;23(4):491‐5. - PubMed
James 2015
    1. James AC, James G, Cowdrey FA, Soler A, Choke A. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews 2015, Issue 2. [DOI: 10.1002/14651858.CD004690.pub4] - DOI - PMC - PubMed
Jones 2012
    1. Jones L, Bellis MA, Wood S, Hughes K, McCoy E, Eckley L, et al. Prevalence and risk of violence against children with disabilities: a systematic review and meta‐analysis of observational studies. The Lancet 2012;380(9845):899‐907. - PubMed
Jordans 2016
    1. Jordans M, Pigott H, Tol WA. Interventions for children affected by armed conflict: a systematic review of mental health and psychosocial support in low‐ and middle‐income countries. Current Psychiatry Report 2016;18(9):1‐15. - PMC - PubMed
Josse 2009
    1. Josse E, Dubois V. Interventions Humanitaires en Santè Mentale Dans Les Violences de Masse. Bruxelles: Groupe de Boeck, 2009.
Jüni 2001
    1. Jüni P, Altman DG, Egger M. Systematic reviews in health care: assessing the quality of controlled clinical trials. British Medical Journal 2001;323:42‐6. - PMC - PubMed
Kaiser 2015
    1. Kaiser BN, Haroz EE, Kohrt BA, Bolton PA, Bass JK, Hinton DE. "Thinking too much": a systematic review of a common idiom of distress. Social Science and Medicine 2015;147:170‐83. - PMC - PubMed
Kane 2017
    1. Kane JC, Luitel NP, Jordans MJ, Kohrt BA, Weissbecker J, Tol WA. Mental health and psychosocial problems in the aftermath of Nepal earthquakes: findings from a representative cluster sample survey. Epidemiology and Psychiatric Sciences 2017;9:1‐10. - PMC - PubMed
Kohrt 2013
    1. Kohrt BA, Rasmussen A, Kaiser BN, Haroz EE, Maharjan SM, Mutamba BB, et al. Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology. International Journal of Epidemiology 2013;43(2):365‐406. - PMC - PubMed
Kroenke 2002
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ‐15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine 2002;64(2):258‐66. - PubMed
Langendam 2013
    1. Langendam MW, Akl EA, Dahm P, Glasziou P, Guyatt G, Schünemann HJ. Assessing and presenting summaries of evidence in Cochrane Reviews. Systematic Reviews 2013;23(2):81. - PMC - PubMed
Markowitz 2004
    1. Markowitz JC, Weissman MM. Interpersonal psychotherapy: principles and applications. World Psychiatry 2004;3(3):136‐9. - PMC - PubMed
Markowitz 2014
    1. Markowitz JC, Lipsitz J, Milrod B. Critical review of outcome research on interpersonal psychotherapy for anxiety disorders. Depression and Anxiety 2014;31(4):316‐25. - PMC - PubMed
Markowitz 2015
    1. Markowitz JC, Petkova E, Neria Y, Meter PE, Zhao Y, Hembree E, et al. Is exposure necessary? A randomized clinical trial of interpersonal psychotherapy for PTSD. American Journal of Psychiatry 2015;172(5):430‐40. - PMC - PubMed
Miller 2016
    1. Miller K, Rasmussen A. The mental health of civilians displaced by armed conflict: an ecological model for refugee distress. Epidemiology and Psychiatric Sciences 2016;4:1‐10. - PMC - PubMed
Mollica 1992
    1. Mollica RF, Caspi‐Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. The Harvard Trauma Questionnaire. Validating a cross‐cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous & Mental Disease 1992;180(2):111‐6. - PubMed
Montgomery 1979
    1. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. British Journal of Psychiatry 1979;134:382‐9. - PubMed
Montgomery 2010
    1. Montgomery EC, Kunik ME, Wilson N, Stanley MA, Weiss B. Can paraprofessionals deliver cognitive‐behavioral therapy to treat anxiety and depressive symptoms?. Bulletin of the Menninger Clinic 2010;74(1):45‐62. - PubMed
Morina 2017
    1. Morina N, Malek M, Nickerson A, Bryant RA. Psychological interventions for post‐traumatic stress disorder and depression in young survivors of mass violence in low‐ and middle‐income countries: meta‐analysis. British Journal of Psychiatry 2017;210:247‐54. - PubMed
Murray 2014
    1. Murray LK, Dorsey S, Haroz E, Lee C, Alsiary MM, Haydary A, et al. A common elements treatment approach for adult mental health problems in low‐ and middle‐income countries. Cognitive Behavioral Practice 2014;21(2):111‐23. - PMC - PubMed
Nader 1996
    1. Nader K, Kriegler JA, Blake DD, Pynoos RS, Newman E, Weather FW. Clinician administered PTSD scale, child and adolescent version. White River Junction (VT): National Center for PTSD; 1996.
O'Donnell 2014
    1. O'Donnell ML, Alkemade N, Nickerson A, Creamer M, McFarlane AC, Silove D, et al. Impact of the diagnostic changes to post‐traumatic stress disorder for DSM‐5 and the proposed changes to ICD‐11. British Journal of Psychiatry 2014;205(3):230‐5. - PubMed
Olthuis 2015
    1. Olthuis JV, Watt MC, Bailey K, Hayden JA, Stewart SH. Therapist‐supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database of Systematic Reviews 2015, Issue 3. [DOI: 10.1002/14651858.CD011565] - DOI - PubMed
Patel 2014
    1. Patel N, Kellezi B, Williams AC. Psychological, social and welfare interventions for psychological health and well‐being of torture survivors. Cochrane Database of Systematic Reviews 2014, Issue 11. [DOI: 10.1002/14651858.CD009317.pub2] - DOI - PMC - PubMed
Purgato 2010
    1. Purgato M, Barbui C, Cipriani A. Assessing risk of bias in randomized controlled trials. Epidemiologia e Psichiatria Sociale 2010;19(4):296‐7. - PubMed
Purgato 2012
    1. Purgato M, Adams CE. Heterogeneity: the issue of apples, oranges and fruit pie. Epidemiology and Psychiatric Sciences 2012;21(1):27‐9. - PubMed
Purgato 2015
    1. Purgato M, Gastaldon C, Papola D, Ommeren M, Barbui C, Tol WA. Psychological therapies for the treatment of mental disorders in low‐ and middle‐income countries affected by humanitarian crises. Cochrane Database of Systematic Reviews 2015, Issue 10. [DOI: 10.1002/14651858.CD011849] - DOI - PMC - PubMed
Purgato 2016a
    1. Purgato M, Gastaldon C, Papola, Ommeren M, Barbui C, Tol WA. Psychological and social interventions for the prevention of mental disorders in people living in low‐ and middle‐income countries affected by humanitarian crises. Cochrane Database of Systematic Reviews 2016, Issue 11. [DOI: 10.1002/14651858.CD012417] - DOI - PMC - PubMed
Purgato 2016b
    1. Purgato M, Tol WA, Bass JK. An ecological model for refugee mental health: implications for research. Epidemiology and Psychiatric Sciences 2016;19:1‐3. - PMC - PubMed
Purgato 2018
    1. Purgato M, Gross AL, Betancourt T, Bolton P, Bonetto C, Gastaldon C, et al. Focused psychosocial interventions for children in low‐resource humanitarian settings: a systematic review and individual participant data meta‐analysis. Lancet Global Health 2018;6(4):e390–e400. [DOI: 10.1016/S2214-109X(18)30046-9] - DOI - PubMed
Rigmor 2010
    1. Rigmor CB, Bjørg H. Effectiveness of psychotherapy for adults with depression: a systematic review of the best available evidence. Procedia ‐ Social and Behavioral Sciences 2010;5:2194‐200.
Savović 2012
    1. Savović J, Jones HE, Altman DG, Harris RJ, Jüni P, Pildal J, et al. Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Annals of Internal Medicine 2012;157(6):429‐38. - PubMed
Schauer 2011
    1. Schauer M, Neuner F, Elbert T. Narrative Exposure Therapy: A short Term Treatment For Traumatic Stress Disorders (2nd edition). Narrative Exposure Therapy: A Short Term Treatment for Traumatic Stress Disorders. 2nd edition. Cambridge, MA: Hogrefe Publishing, 2011.
Sheehan 1998
    1. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini‐International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM‐IV and ICD‐10. Journal of Clinical Psychiatry 1998;59(20):22‐33. - PubMed
The Lancet 2016
    1. The Lancet. Health ‐ an explicit human right. The Lancet 2016;387:917. - PubMed
The Sphere Project 2011
    1. The Sphere Project. Humanitarian charter and minimum standards in humanitarian response. www.sphereproject.org/. Accessed 3 August 2015.
Themner 2014
    1. Themner L, Wallensteen P. Armed conflicts, 1946‐2013. Journal of Peace Research 2014;51(4):541‐54.
Tol 2011
    1. Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. The Lancet 2011;378(9802):1581‐91. - PMC - PubMed
Tol 2011a
    1. Tol WA, Komproe IH, Jordans MJ, Susanty D, Jong JT. Developing a function impairment measure for children affected by political violence: a mixed methods approach in Indonesia. International Journal for Quality in Health Care 2011;23(4):375‐83. - PubMed
Ukoumunne 1999
    1. Ukoumunne OC, Gulliford MC, Chinn S, Sterne JA, Burney PG. Methods for evaluating area‐wide and organisation‐based interventions in health and health care: a systematic review. Health Technology Assessment 1999;3(5):92. - PubMed
UN General Assembly 1996
    1. UN General Assembly. Impact of armed conflict on children. www.refworld.org/docid/3b00f2d30.html. Accessed 23 March 2017.
UNICEF 2009
    1. Office of the Special Representative of the Secretary‐General for Children and Armed Conflict in collaboration with UNICEF. Machel Study 10‐Year Strategic Review: Children and Conflict in a Changing World. www.unicef.org/publications/index_49985.html. Accessed 3 August 2015.
US Department of Health and Human Services 2014
    1. US Department of Health and Human Services. Trauma‐Informed Care in Behavioral Health Services. Rockville, MD: SAMHSA Publications, 2014.
van Dessel 2014
    1. Dessel N, Boeft M, Wouden JC, Kleinstäuber M, Leone SS, Terluin B, et al. Non‐pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults. Cochrane Database of Systematic Reviews 2014, Issue 11. [DOI: 10.1002/14651858.CD011142.pub2] - DOI - PMC - PubMed
Watanabe 2007
    1. Watanabe N, Hunot V, Omori IM, Churchill R, Furukawa TA. Psychotherapy for depression among children and adolescents: a systematic review. Acta Psychiatrica Scandinavica 2007;116(2):84‐95. - PubMed
Watts 2015
    1. Watts SE, Turnell A, Kladnitski N, Newby JM, Andrews G. Treatment‐as‐usual (TAU) is anything but usual: a meta‐analysis of CBT versus TAU for anxiety and depression. Journal of Affective Disorders 2015;175:152‐67. - PubMed
Weathers 1993
    1. Weathers F, Litz B, Herman D, Huska J, Keane T. The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Annual Convention of the International Society for Traumatic Stress Studies; San Antonio, TX, October 1993. International Society for Traumatic Stress Studies.
Weiss 1997
    1. Weiss D, Marmar C. The impact of event scale—revised. In: Wilson, JP editor(s). Assessing Psychological Trauma and PTSD. New York: Guilford Press, 1997:399‐411.
WHO 1978
    1. World Health Organization (WHO). The Ninth Revision of the International Classification of Diseases and Related Health Problems (ICD‐9). Geneva: WHO, 1978.
WHO 1992
    1. World Health Organization (WHO). The ICD‐10 Classification of Mental and Behavioural Disorders. Geneva: WHO, 1992.
WHO 1997
    1. Division of mental health and prevention of substance abuse World Health Organization (WHO). WHOQOL. Measuring Quality of Life. Geneva: WHO, 1997.
WHO 2010
    1. World Health Organization (WHO). Measuring Health and Disability: Manual for WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). In: Ustun TB, Kostanjsek N, Chatterji S, Rehm J editor(s). Measuring Health and Disability: Manual for WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Geneva: WHO, 2010.
WHO 2012
    1. World Health Organization (WHO). Assessing Mental Health and Psychosocial Needs and Resources: Assessment Toolkit for Humanitarian Settings. Geneva: WHO, 2012.
WHO 2013
    1. World Health Organization (WHO). Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: WHO, 2013. - PubMed
WHO 2016
    1. World Health Organization (WHO). mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non‐specialized Health Settings. Vol. Version 2.0, Geneva: Department of Mental Health and Substance Abuse, WHO, 2016. - PubMed
World Bank 2013
    1. World Bank. Country and leading groups. data.worldbank.org/about/country‐classifications/country‐and‐lending‐groups. Accessed 6 May 2014.
Zigmond 1983
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 1983;67(6):361‐70. - PubMed

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