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Randomized Controlled Trial
. 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

Marianna Purgato  1   2 , Kenneth Carswell  3 , Federico Tedeschi  1 , Ceren Acarturk  4 , Minna Anttila  5 , Teresa Au  3 , Malek Bajbouj  6 , Josef Baumgartner  7 , Massimo Biondi  8 , Rachel Churchill  9 , Pim Cuijpers  10   11 , Markus Koesters  12 , Chiara Gastaldon  1   2 , Zeynep Ilkkursun  4 , Tella Lantta  5 , Michela Nosè  1   2 , Giovanni Ostuzzi  1   2 , Davide Papola  1   2 , Mariana Popa  13 , Valentina Roselli  8 , Marit Sijbrandij  10   11 , Lorenzo Tarsitani  8 , Giulia Turrini  1   2 , Maritta Välimäki  5 , Lauren Walker  14 , Johannes Wancata  7 , Elisa Zanini  1 , Ross White  13 , Mark van Ommeren  3 , Corrado Barbui  1   2
Affiliations
Randomized Controlled Trial

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

Marianna Purgato et al. Psychother Psychosom. 2021.

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.

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

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram.
Fig. 2
Fig. 2
Trend in the frequency of any mental disorders over time.
See this image and copyright information in PMC

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