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Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies (The Lancet Regional Health – Europe)

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Home / Resources / Anxiety/Panic/Phobias / Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies (The Lancet Regional Health – Europe)

Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies

Systematic review to identify randomized clinical trials assessing the efficacy of psychosocial interventions for migrant populations in reducing symptoms of post-traumatic stress disorder (PTSD), depression or anxiety.


Article Abstract

“Background: Migrant populations are at increased risk of developing mental health problems. We aimed to compare the efficacy and acceptability of psychosocial interventions in this population.

Methods: We conducted a systematic review and network meta-analysis (NMA). Cochrane Central Register of randomised trials (CENTRAL), MEDLINE, PTSDpubs, PsycINFO, PubMed, CINAHL, EMBASE, Web of Science, Scopus, and ClinicalTrials.gov were searched from database inception to October 7, 2024, to identify randomized clinical trials assessing the efficacy of psychosocial interventions for migrant populations in reducing symptoms of post-traumatic stress disorder (PTSD), depression or anxiety. Studies with second-generation migrants were excluded if they comprised over 20% of participants. Two independent researchers screened, reviewed, and extracted data. The primary outcomes were the severity of PTSD, depression, and anxiety symptoms at post-intervention. Secondary outcomes included acceptability. Standardised mean differences (SMDs) and risk ratios (RRs) were pooled using pairwise and NMA. PROSPERO: CRD42023418817.

Findings: Of the 103 studies with 19,230 participants included, 96 contributed to the meta-analyses for at least one outcome, with women representing 64% of the participants. Narrative Exposure Therapy (NET), counselling, Eye Movement Desensitization and Reprocessing (EMDR), and creative expressive interventions demonstrated greater efficacy than treatment as usual (TAU) in reducing PTSD symptoms, with SMDs [95% Confidence Intervals (CIs)] ranging from −0.69 [−1.14, −0.24] to −0.60 [−1.20, −0.01], albeit with low confidence in the evidence. For depressive symptoms, Integrative therapy emerged as the top intervention compared to TAU, with moderate confidence (SMD [95% CI] = −0.70 [−1.21, −0.20]). For anxiety symptoms, NET, Integrative therapy, and Problem Management Plus (PM+)/Step-by-Step (SbS) were more effective than TAU, with SMDs [95% CIs] ranging from −1.32 [−2.05, −0.59] to −0.35 [−0.65, −0.05]. Still, the confidence in the evidence was low. Overall, head-to-head comparisons yielded inconclusive results, and the acceptability analysis revealed variations across interventions. 16% of the studies (17 studies) were classified as “high risk” of bias, 68% (70) as having “some concerns”, and 18% (19) as “low risk”. We identified considerable heterogeneity (I2 of >70%).

Interpretation: The analysis revealed no clear differences in the efficacy of psychosocial interventions compared to TAU for reducing symptoms of PTSD, depression, and anxiety. While certain interventions showed potential benefits, confidence in these findings was generally low, limiting the ability to draw definitive conclusions about their comparative effectiveness.”

—Description from publisher

Article Access

Open Access 

Turrini, G., Purgato, M., Cadorin, C., Bartucz, M., Cristofalo, D., Gastaldon, C., Nosè, M., Ostuzzi, G., Papola, D., Prina, E., Tedeschi, F., Witteveen, A. B., Sijbrandij, M., & Barbui, C. (2025). Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies. The Lancet Regional Health – Europe, 48: 101152. Open access: https://doi.org/10.1016/j.lanepe.2024.101152

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Basic Info Collapse

Date
January 1, 2025

Creator(s)
Giulia Turrini, Marianna Purgato, Camilla Cadorin

Contributor(s)
Monica Bartucz, Doriana Cristofalo, Chiara Gastaldon, Michela Nosè, Giovanni Ostuzzi, Davide Papola, Eleonora Prina, Federico Tedeschi, Anke B Witteveen, Marit Sijbrandij, Corrado Barbui

Topics
Anxiety/Panic/Phobias, Depression, PTSD

Client Population
Immigrants/Refugees

More Info Collapse

Extent
17 pages

Publisher
Elsevier Ltd

Rights
Copyright © 2024 The Author(s). This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

APA Citation
Turrini, G., Purgato, M., Cadorin, C., Bartucz, M., Cristofalo, D., Gastaldon, C., Nose, M., Ostuzzi, G., Papola, D., Prina, E., Tedeschi, F., Witteveen, A. B., Sijbrandij, M., & Barbui, C. (2025). Comparative efficacy and acceptability of psychosocial interventions for PTSD, depression, and anxiety in asylum seekers, refugees, and other migrant populations: a systematic review and network meta-analysis of randomised controlled studies. The Lancet Regional Health - Europe, 48: 101152. Open access: https://doi.org/10.1016/j.lanepe.2024.101152

Audience
Other Mental Health Professionals

Language
English

Content Type
Article, Meta-analyses/Systematic Reviews, Peer-Reviewed

Access Type
External Resource, Open Access

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