背景:难民,寻求庇护者,和国内流离失所者由于经历创伤和压力事件而经历精神健康问题的沉重负担。目的:总结现有证据,分析简短的心理干预(<3个月)对改善心理健康结果的疗效。包括抑郁症,焦虑,和难民的创伤后应激障碍(PTSD)相关症状。方法:我们搜索了Medline,EMBASE,PsycINFO,CINAHL,和全球指数从成立到2023年12月19日。我们纳入了在短时间内(<3个月)使用任何认知行为疗法(CBT)或基于CBT的疗法的对照研究。报告了干预前后的心理健康结果。我们使用随机效应进行了荟萃分析,以得出汇总统计量。使用Cochrane偏差风险(RoB2)和ROBINS-I工具评估证据的质量。这项研究在开放科学框架上注册,DOI10.17605/OSF.IO/9CXU4。结果:检索了37篇出版物中的34项合格研究进行分析,荟萃分析中纳入了33项研究,包括4479名参与者.所有三个领域的即时心理健康结果都有了总体改善,分析了13项关于焦虑结局的研究(SMD-1.12,95%CI-1.72至-0.52),20项抑郁症研究(SMD-1.04,95%CI-1.97至-0.11),和24项关于创伤后应激障碍的研究(SMD-0.82,95%CI-1.20至-0.45)。在3至6个月的随访中,然而,对心理健康结果的分析显示,与基线相比没有显著变化,在4项研究中,SMD为0.24(95%CI-0.94至1.42),在9项研究中-0.73(95%CI-2.14至0.68),在12项焦虑研究中,0.29项(95%CI-0.94至1.53),抑郁症,和PTSD分别。结论:低质量证据表明,简短的心理干预对难民和国内流离失所者的心理健康具有积极的立竿见影的作用。然而,这些影响在短期随访中不会持续。异质性很高,即使在亚组中,影响我们的发现的普遍性。
我们分析了使用简短的基于CBT的心理干预措施来改善被迫流离失所者的心理健康结果的证据。这些干预措施对焦虑有积极的影响,抑郁症和创伤后应激障碍,尽管研究之间存在高度异质性。对心理健康的积极影响在长期随访中消失了。
Background: Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.Objective: To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.Method: We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4.Results: 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.Conclusion: Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people\'s mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings\' generalisability.
We analysed the evidence on the use of brief CBT-based psychological interventions to improve mental health outcomes in forcibly displaced persons.These interventions had a positive effect on anxiety, depression and PTSD, though there was high heterogeneity between studies.Positive effects on mental health disappeared at long-term follow-up.