Abstract
Background: Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention. Methods: Refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. Results: There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. Conclusions: gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT. Trial registration: ClinicalTrials.gov Identifier NCT03567083; date: 25/06/2018.
| Original language | English |
|---|---|
| Article number | 8 |
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | BMC Psychiatry |
| Volume | 22 |
| DOIs | |
| Publication status | Published - 4 Jan 2022 |
Bibliographical note
Funding Information:This study was conducted within the framework of the STRENGTHS-Consortium. The authors would like to thank the team members who took part in the field work including the interviewers, assessors, and the facilitators. This pilot trial was also supported by the Refugee and Asylum Seekers Assistance and Solidarity Association (RASASA) and the authors would like to thank the employees of RASASA who have took part in the organization of the field. Lastly, the authors would like to thank the participants and their family members who were willing to participate in the project.
Funding Information:
The study is funded by the European Union’s Horizon 2020 Research and Innovation programme Societal Challenges under Grant Agreement No 733337.
Publisher Copyright:
© 2021, The Author(s).
Funding
This study was conducted within the framework of the STRENGTHS-Consortium. The authors would like to thank the team members who took part in the field work including the interviewers, assessors, and the facilitators. This pilot trial was also supported by the Refugee and Asylum Seekers Assistance and Solidarity Association (RASASA) and the authors would like to thank the employees of RASASA who have took part in the organization of the field. Lastly, the authors would like to thank the participants and their family members who were willing to participate in the project. The study is funded by the European Union’s Horizon 2020 Research and Innovation programme Societal Challenges under Grant Agreement No 733337.
Keywords
- Common mental health problems
- Feasibility
- Group intervention
- Pilot
- Randomised controlled trial
- Refugees
- Task sharing