Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus

STRENGTHS Consortium; Anne M de Graaff; Pim Cuijpers; Jos W R Twisk; Barbara Kieft; Sam Hunaidy; Mariam Elsawy; Noer Gorgis; Theo K Bouman; Miriam J J Lommen; Ceren Acarturk; Richard Bryant; Sebastian Burchert; Katie S Dawson; Daniela C Fuhr; Pernille Hansen; Mark Jordans; Christine Knaevelsrud; David McDaid; Naser Morina; Hanspeter Moergeli; A-La Park; Bayard Roberts; Peter Ventevogel; Nana Wiedemann; Aniek Woodward; Marit Sijbrandij

doi:10.1136/bmjment-2022-300637

Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus

STRENGTHS Consortium
, Anne M de Graaff
, Pim Cuijpers
, Jos W R Twisk
, Barbara Kieft
, Sam Hunaidy
, Mariam Elsawy
, Noer Gorgis
, Theo K Bouman
, Miriam J J Lommen
, Ceren Acarturk
, Richard Bryant
, Sebastian Burchert
, Katie S Dawson
, Daniela C Fuhr
, Pernille Hansen
, Mark Jordans
, Christine Knaevelsrud
, David McDaid
, Naser Morina

Hanspeter Moergeli, A-La Park, Bayard Roberts, Peter Ventevogel, Nana Wiedemann, Aniek Woodward, Marit Sijbrandij

Clinical Psychology and Experimental Psychopathology

Research output: Contribution to journal › Article › Academic › peer-review

55 Citations (Scopus)

183 Downloads (Pure)

Abstract

BACKGROUND: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.

OBJECTIVE: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.

METHODS: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019-December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.

FINDINGS: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference -0.25; 95% CI -0.385 to -0.122; p=0.0001, Cohen's d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d=0.42), anxiety (p=0.001, Cohen's d=0.27), PTSD symptoms (p=0.0005, Cohen's d=0.39) and self-identified problems (p=0.03, Cohen's d=0.26), but not on impairment (p=0.084, Cohen's d=0.21).

CONCLUSIONS: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.

CLINICAL IMPLICATIONS: Peer-provided psychological interventions should be considered for scale-up in HICs.

Original language	English
Article number	e300637
Number of pages	10
Journal	BMJ mental health
Volume	26
Issue number	1
DOIs	https://doi.org/10.1136/bmjment-2022-300637
Publication status	Published - Feb-2023

Keywords

Adult
Male
Humans
Female
Psychosocial Intervention
Depression/therapy
Refugees/psychology
Syria
Single-Blind Method

Access to Document

10.1136/bmjment-2022-300637Licence: CC BY

Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management PlusFinal publisher's version, 996 KBLicence: CC BY

Handle.net

Persistent link

Cite this

STRENGTHS Consortium, de Graaff, A. M., Cuijpers, P., Twisk, J. W. R., Kieft, B., Hunaidy, S., Elsawy, M., Gorgis, N., Bouman, T. K., Lommen, M. J. J., Acarturk, C., Bryant, R., Burchert, S., Dawson, K. S., Fuhr, D. C., Hansen, P., Jordans, M., Knaevelsrud, C., McDaid, D., ... Sijbrandij, M. (2023). Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus. BMJ mental health, 26(1), Article e300637. https://doi.org/10.1136/bmjment-2022-300637

@article{25b45dab0848406fb2d5e938e24d4e2e,

title = "Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus",

abstract = "BACKGROUND: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.OBJECTIVE: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.METHODS: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019-December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.FINDINGS: Participants (n=206; mean age=37 years, 62\% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference -0.25; 95\% CI -0.385 to -0.122; p=0.0001, Cohen's d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d=0.42), anxiety (p=0.001, Cohen's d=0.27), PTSD symptoms (p=0.0005, Cohen's d=0.39) and self-identified problems (p=0.03, Cohen's d=0.26), but not on impairment (p=0.084, Cohen's d=0.21). CONCLUSIONS: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.CLINICAL IMPLICATIONS: Peer-provided psychological interventions should be considered for scale-up in HICs.",

keywords = "Adult, Male, Humans, Female, Psychosocial Intervention, Depression/therapy, Refugees/psychology, Syria, Single-Blind Method",

author = "\{STRENGTHS Consortium\} and \{de Graaff\}, \{Anne M\} and Pim Cuijpers and Twisk, \{Jos W R\} and Barbara Kieft and Sam Hunaidy and Mariam Elsawy and Noer Gorgis and Bouman, \{Theo K\} and Lommen, \{Miriam J J\} and Ceren Acarturk and Richard Bryant and Sebastian Burchert and Dawson, \{Katie S\} and Fuhr, \{Daniela C\} and Pernille Hansen and Mark Jordans and Christine Knaevelsrud and David McDaid and Naser Morina and Hanspeter Moergeli and A-La Park and Bayard Roberts and Peter Ventevogel and Nana Wiedemann and Aniek Woodward and Marit Sijbrandij",

note = "{\textcopyright} Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.",

year = "2023",

month = feb,

doi = "10.1136/bmjment-2022-300637",

language = "English",

volume = "26",

journal = "BMJ mental health",

issn = "2755-9734",

publisher = "BMJ Publishing Group",

number = "1",

}

STRENGTHS Consortium, de Graaff, AM, Cuijpers, P, Twisk, JWR, Kieft, B, Hunaidy, S, Elsawy, M, Gorgis, N, Bouman, TK , Lommen, MJJ, Acarturk, C, Bryant, R, Burchert, S, Dawson, KS, Fuhr, DC, Hansen, P, Jordans, M, Knaevelsrud, C, McDaid, D, Morina, N, Moergeli, H, Park, A-L, Roberts, B, Ventevogel, P, Wiedemann, N, Woodward, A & Sijbrandij, M 2023, 'Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus', BMJ mental health, vol. 26, no. 1, e300637. https://doi.org/10.1136/bmjment-2022-300637

TY - JOUR

T1 - Peer-provided psychological intervention for Syrian refugees

T2 - results of a randomised controlled trial on the effectiveness of Problem Management Plus

AU - STRENGTHS Consortium

AU - de Graaff, Anne M

AU - Cuijpers, Pim

AU - Twisk, Jos W R

AU - Kieft, Barbara

AU - Hunaidy, Sam

AU - Elsawy, Mariam

AU - Gorgis, Noer

AU - Bouman, Theo K

AU - Lommen, Miriam J J

AU - Acarturk, Ceren

AU - Bryant, Richard

AU - Burchert, Sebastian

AU - Dawson, Katie S

AU - Fuhr, Daniela C

AU - Hansen, Pernille

AU - Jordans, Mark

AU - Knaevelsrud, Christine

AU - McDaid, David

AU - Morina, Naser

AU - Moergeli, Hanspeter

AU - Park, A-La

AU - Roberts, Bayard

AU - Ventevogel, Peter

AU - Wiedemann, Nana

AU - Woodward, Aniek

AU - Sijbrandij, Marit

PY - 2023/2

Y1 - 2023/2

N2 - BACKGROUND: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.OBJECTIVE: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.METHODS: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019-December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.FINDINGS: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference -0.25; 95% CI -0.385 to -0.122; p=0.0001, Cohen's d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d=0.42), anxiety (p=0.001, Cohen's d=0.27), PTSD symptoms (p=0.0005, Cohen's d=0.39) and self-identified problems (p=0.03, Cohen's d=0.26), but not on impairment (p=0.084, Cohen's d=0.21). CONCLUSIONS: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.CLINICAL IMPLICATIONS: Peer-provided psychological interventions should be considered for scale-up in HICs.

AB - BACKGROUND: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.OBJECTIVE: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.METHODS: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019-December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.FINDINGS: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference -0.25; 95% CI -0.385 to -0.122; p=0.0001, Cohen's d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d=0.42), anxiety (p=0.001, Cohen's d=0.27), PTSD symptoms (p=0.0005, Cohen's d=0.39) and self-identified problems (p=0.03, Cohen's d=0.26), but not on impairment (p=0.084, Cohen's d=0.21). CONCLUSIONS: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.CLINICAL IMPLICATIONS: Peer-provided psychological interventions should be considered for scale-up in HICs.

KW - Adult

KW - Male

KW - Humans

KW - Female

KW - Psychosocial Intervention

KW - Depression/therapy

KW - Refugees/psychology

KW - Syria

KW - Single-Blind Method

U2 - 10.1136/bmjment-2022-300637

DO - 10.1136/bmjment-2022-300637

M3 - Article

C2 - 36789918

SN - 2755-9734

VL - 26

JO - BMJ mental health

JF - BMJ mental health

IS - 1

M1 - e300637

ER -

Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus

Abstract

Keywords

Access to Document

Handle.net

Fingerprint

Cite this