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

  • C. Barbui (Contributor)
  • F. Tedeschi (Contributor)
  • M. Nosè (Contributor)
  • M. Popa (Contributor)
  • Malek Bajbouj (Contributor)
  • M. van Ommeren (Contributor)
  • Valentina Roselli (Contributor)
  • Maritta V?lim?ki (Contributor)
  • R. White (Contributor)
  • Davide Papola (Contributor)
  • M. Purgato (Contributor)
  • Pim Cuijpers (Contributor)
  • G. Ostuzzi (Contributor)
  • M. Koesters (Contributor)
  • R. Churchill (Contributor)
  • Lorenzo Tarsitani (Contributor)
  • Massimo Biondi (Contributor)
  • C. Acarturk (Contributor)
  • Chiara Gastaldon (Contributor)
  • Zeynep Ilkkursun (Contributor)
  • Lauren Walker (Contributor)
  • M. Anttila (Contributor)
  • J. Wancata (Contributor)
  • T. Au (Contributor)
  • Josef Baumgartner (Contributor)
  • Elisa Zanini (Contributor)
  • K. Carswell (Contributor)
  • T. Lantta (Contributor)
  • G. Turrini (Contributor)
  • Marit Sijbrandij (Contributor)



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.
Date made available1 Jan 2021
Publisherfigshare Academic Research System

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