Nexhmedin Morina1, Mina Malek2, Angela Nickerson3, Richard A Bryant3. 1. Department of Psychology, University of Münster, Münster, Germany. 2. Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. 3. School of Psychology, University of New South Wales, Sydney, NSW, Australia.
Abstract
BACKGROUND: Most survivors of mass violence live in low- and middle-income countries (LMICs). We conducted a meta-analysis of randomized controlled psychotherapy trials for adult posttraumatic stress disorder (PTSD) and/or depression in LMICs. METHODS: We included 18 clinical trials (3,058 participants), in which 25 and 18 treatment arms measured symptoms of PTSD and depression, respectively. RESULTS: Active treatments for PTSD yielded a large aggregated pre-post effect size (g = 1.29; 95% CI = [0.99; 1.59]) and a small to medium effect size at posttreatment when compared to control conditions (g = 0.39; 95% CI = [0.24; 0.55]). Effect sizes were similar for pretreatment versus follow-up (g = 1.75; 95% CI = [1.17; 2.32]) and in comparison to waitlist at follow-up (g = 0.93; 95% CI = [0.56; 1.31]). Active treatments for depression produced large pre-post (g = 1.28; 95% CI = [0.96; 1.61]) and controlled effect sizes (posttreatment, comparison to control conditions, g = 0.86; 95% CI = [0.54; 1.18]). CONCLUSIONS: Our findings suggest that psychological interventions can effectively reduce symptoms of PTSD and depression in LMICs. Future research needs to focus on cost-effective interventions that are likely to be disseminated to the large numbers of war survivors in LMICs.
BACKGROUND: Most survivors of mass violence live in low- and middle-income countries (LMICs). We conducted a meta-analysis of randomized controlled psychotherapy trials for adult posttraumatic stress disorder (PTSD) and/or depression in LMICs. METHODS: We included 18 clinical trials (3,058 participants), in which 25 and 18 treatment arms measured symptoms of PTSD and depression, respectively. RESULTS: Active treatments for PTSD yielded a large aggregated pre-post effect size (g = 1.29; 95% CI = [0.99; 1.59]) and a small to medium effect size at posttreatment when compared to control conditions (g = 0.39; 95% CI = [0.24; 0.55]). Effect sizes were similar for pretreatment versus follow-up (g = 1.75; 95% CI = [1.17; 2.32]) and in comparison to waitlist at follow-up (g = 0.93; 95% CI = [0.56; 1.31]). Active treatments for depression produced large pre-post (g = 1.28; 95% CI = [0.96; 1.61]) and controlled effect sizes (posttreatment, comparison to control conditions, g = 0.86; 95% CI = [0.54; 1.18]). CONCLUSIONS: Our findings suggest that psychological interventions can effectively reduce symptoms of PTSD and depression in LMICs. Future research needs to focus on cost-effective interventions that are likely to be disseminated to the large numbers of war survivors in LMICs.
Authors: Justin Cikuru; Ali Bitenga; Juvenal Bazilashe Mukungu Balegamire; Prince Mujumbe Salama; Michelle M Hood; Bhramar Mukherjee; Alain Mukwege; Sioban D Harlow Journal: Glob Ment Health (Camb) Date: 2021-04-20
Authors: Paula P Schnurr; Richard Bryant; Lucy Berliner; Dean G Kilpatrick; Albert Rizzo; Josef I Ruzek Journal: Eur J Psychotraumatol Date: 2017-10-27