{Reference Type}: Meta-Analysis
{Title}: Self-Help Plus for refugees and asylum seekers: an individual participant data meta-analysis.
{Author}: Karyotaki E;Sijbrandij M;Purgato M;Acarturk C;Lakin D;Bailey D;Peckham E;Uygun E;Tedeschi F;Wancata J;Augustinavicius J;Carswell K;Välimäki M;van Ommeren M;Koesters M;Popa M;Leku MR;Anttila M;Churchill R;White RG;Al-Hashimi S;Lantta T;Au T;Klein T;Tol WA;Cuijpers P;Barbui C;
{Journal}: BMJ Ment Health
{Volume}: 26
{Issue}: 1
{Year}: 2023 Jul
暂无{DOI}: 10.1136/bmjment-2023-300672
{Abstract}: <B>OBJECTIVE: </B>Refugees and asylum seekers are at high risk of mental disorders due to various stressors before, during and after forceful displacement. The WHO Self-Help Plus (SH+) intervention was developed to manage psychological distress and a broad range of mental health symptoms in vulnerable populations. This study aimed to examine the effects and moderators of SH+ compared with Enhanced Care as Usual (ECAU) in reducing depressive symptoms among refugees and asylum seekers.<BR><B>METHODS: </B>Three randomised trials were identified with 1795 individual participant data (IPD). We performed an IPD meta-analysis to estimate the effects of SH+, primarily on depressive symptoms and second on post-traumatic stress, well-being, self-identified problems and functioning. Effects were also estimated at 5-6 months postrandomisation (midterm).<BR><B>RESULTS: </B>There was no evidence of a difference between SH+ and ECAU+ in reducing depressive symptoms at postintervention. However, SH+ had significantly larger effects among participants who were not employed (β=1.60, 95% CI 0.20 to 3.00) and had lower mental well-being levels (β=0.02, 95% CI 0.001 to 0.05). At midterm, SH+ was significantly more effective than ECAU in improving depressive symptoms (β=-1.13, 95% CI -1.99 to -0.26), self-identified problems (β=-1.56, 95% CI -2.54 to -0.59) and well-being (β=6.22, 95% CI 1.60 to 10.90).<BR><B>CONCLUSIONS: </B>Although SH+ did not differ significantly from ECAU in reducing symptoms of depression at postintervention, it did present benefits for particularly vulnerable participants (ie, unemployed and with lower mental well-being levels), and benefits were also evident at midterm follow-up. These results are promising for the use of SH+ in the management of depressive symptoms and improvement of well-being and self-identified problems among refugees and asylum seekers.