Meta-analysis of interventions for posttraumatic stress disorder and depression in adult survivors of mass violence in low- and middle-income countries
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BACKGROUND: Most survivors of mass violence live in low- and middle-income countries (LMICs). We conducted a meta-analysis of randomized controlled psychotherapy trials for adult posttraumatic stress disorder (PTSD) and/or depression in LMICs. METHODS: We included 18 clinical trials (3,058 participants), in which 25 and 18 treatment arms measured symptoms of PTSD and depression, respectively. RESULTS: Active treatments for PTSD yielded a large aggregated pre-post effect size (g = 1.29; 95% CI = [0.99; 1.59]) and a small to medium effect size at posttreatment when compared to control conditions (g = 0.39; 95% CI = [0.24; 0.55]). Effect sizes were similar for pretreatment versus follow-up (g = 1.75; 95% CI = [1.17; 2.32]) and in comparison to waitlist at follow-up (g = 0.93; 95% CI = [0.56; 1.31]). Active treatments for depression produced large pre-post (g = 1.28; 95% CI = [0.96; 1.61]) and controlled effect sizes (posttreatment, comparison to control conditions, g = 0.86; 95% CI = [0.54; 1.18]). CONCLUSIONS: Our findings suggest that psychological interventions can effectively reduce symptoms of PTSD and depression in LMICs. Future research needs to focus on cost-effective interventions that are likely to be disseminated to the large numbers of war survivors in LMICs.
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Low-intensity psychological interventions have been developed to increase access to appropriate mental health care without burdening healthcare systems.
“Low-intensity psychological interventions have been developed to increase access to appropriate mental health care without burdening healthcare systems (Morina, Malek, Nickerson, & Bryant, 2017).”
From Feasibility trial of a scalable transdiagnostic group psychological intervention for Syrians residing in a refugee camp (2021) · cites this paper as Morina, Malek, Nickerson, & Bryant, 2017
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Decision: Scalable interventions for refugees — R0/PR7
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr7
Review: Scalable interventions for refugees — R1/PR9
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr9
Recommendation: Scalable interventions for refugees — R0/PR5
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr5
Author comment: Scalable interventions for refugees — R0/PR1
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr1
Self-citationReview: Scalable interventions for refugees — R0/PR4
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr4
Review: Scalable interventions for refugees — R0/PR3
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr3
Recommendation: Scalable interventions for refugees — R1/PR12
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr12
Review: Scalable interventions for refugees — R1/PR11
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr11
Decision: Scalable interventions for refugees — R0/PR6
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr6
Decision: Scalable interventions for refugees — R1/PR13
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr13
Review: Scalable interventions for refugees — R0/PR2
Bryant, R. A. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.59.pr2
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- Authors
- Morina, N., Malek, M., Nickerson, A., & Bryant, R. A.
- Affiliations
- Department of Psychology; University of Münster; Münster Germany
- University of Amsterdam (NL)
- UNSW Sydney (AU)
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2017-04-18
- Volume
- 34
- Issue
- 8
- Pages
- 679-691
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W2606621731
- Cited by
- 85
- References
- 67
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 23 · 2021: 17 · 2020: 7 · 2019: 10 · 2018: 6 · 2017: 2
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- Netherlands Institute for Advanced Study in the Humanities and Social Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- post-traumatic stress disorder, depression, psychotherapeutic interventions, low- and middle-income countries, war survivors, psychological intervention, treatment effect size, cost-effective interventions
- MeSH terms
- Adult, Depressive Disorder, Developing Countries, Female, Humans, Male, Psychotherapy, Stress Disorders, Post-Traumatic, Violence, Outcome Assessment, Health Care, Survivors
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