The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
World Health Organization's low‐intensity psychosocial interventions: a systematic review and meta‐analysis of the effects of Problem Management Plus and Step‐by‐Step
Open accessAbstract
Many societies have been recently exposed to humanitarian and health emergencies, which have resulted in a large number of people experiencing significant distress and being at risk to develop mental disorders such as depression, anxiety and post‐traumatic stress disorder. The World Health Organization has released a series of scalable psychosocial interventions for people impaired by distress in communities exposed to adversities. Prominent among these is a low‐intensity transdiagnostic psychosocial intervention, Problem Management Plus (PM+), and its digital adaptation Step‐by‐Step (SbS). This systematic review is the first to summarize the available evidence on the effects of PM+ and SbS. Up to March 8, 2023, five databases were searched for randomized controlled trials examining the effects of PM+ or SbS on distress indicators (i.e., general distress; anxiety, depressive or post‐traumatic stress disorder symptoms; functional impairment, self‐identified problems) and positive mental health outcomes (i.e., well‐being, quality of life, social support/relationships). We performed random‐effects multilevel meta‐analyses on standardized mean differences (SMDs) at post‐intervention and short‐term follow‐up assessments. Our search yielded 23 eligible studies, including 5,298 participants. We found a small to medium favorable effect on distress indicators (SMD=–0.45, 95% CI: –0.56 to –0.34) and a small beneficial effect on positive mental health outcomes (SMD=0.31, 95% CI: 0.14‐0.47), which both remained significant at follow‐up assessment and were robust in sensitivity analyses. However, our analyses pointed to substantial between‐study heterogeneity, which was only partially explained by moderators, and the certainty of evidence was very low across all outcomes. These results provide evidence for the effectiveness of PM+ and SbS in reducing distress indicators and promoting positive mental health in populations exposed to adversities, but a larger high‐quality evidence base is needed, as well as research on participant‐level moderators of the effects of these interventions, their suitability for stepped‐care programs, and their cost‐effectiveness.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It has proven to be particularly effective in reducing the symptoms of anxiety, depression, and general distress in settings affected by significant adversity, including conflict-affected regions or under-resourced settings [16].”
From A Digital Tool (Technology-Assisted Problem Management Plus) for Lay Health Workers to Address Common Mental Health Disorders: Co-production and Usability Study in Pakistan (2025) · cites this paper as [16]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
RoB 2: a revised tool for assessing risk of bias in randomised trials
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., et al. (2019) · BMJ · doi:10.1136/bmj.l4898 · Cited by 34,787
Rayyan-a web and mobile app for systematic reviews.
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0384-4 · Cited by 26,092
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464
Santomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02143-7 · Cited by 5,444
Some Methods for Strengthening the Common χ 2 Tests
Cochran, W. G. (1954) · Biometrics · doi:10.2307/3001616 · Cited by 3,718
Doing Meta-Analysis with R: A Hands-On Guide
Harrer, M., Cuijpers, P., Furukawa, T. A., & Ebert, D. D. (2021) · doi:10.1201/9781003107347 · Cited by 1,850
Romanello, M., Di Napoli, C., Drummond, P., Green, C., Kennard, H., Lampard, P., Scamman, D., Arnell, N., Ayeb-Karlsson, S., Ford, L. B., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01540-9 · Cited by 1,710
United Nations High Commissioner for Refugees
Petit, P. (2017) · Routledge eBooks · doi:10.4324/9781315129310-7 · Cited by 1,680
Research works printed but not linked: 3
- World Health Organization, 2017, Scalable psychological interventions for people in communities affected by adversity
- World Health Organization, 2018, Problem Management Plus (PM+): individual psychological help for adults impaired by distress in communities exposed to adversity
- Schünemann HJ, Cochrane handbook for systematic reviews of interventions version 6.3
Cited by
Sorted by citations
Brewin, C. R., Atwoli, L., Bisson, J. I., Galea, S., Koenen, K. C., & Lewis‐Fernández, R. (2025) · World Psychiatry · doi:10.1002/wps.21269 · Cited by 121
Digital interventions to promote psychological resilience: a systematic review and meta-analysis
Schäfer, S. K., von Boros, L., Schaubruch, L. M., Kunzler, A. M., Lindner, S., Koehler, F., Werner, T., Zappalà, F., Helmreich, I., Wessa, M., et al. (2024) · npj Digital Medicine · doi:10.1038/s41746-024-01017-8 · Cited by 122
Self-citationIs There a Burnout Epidemic among Medical Students? Results from a Systematic Review
Vincenzo, M. D., Arsenio, E., Rocca, B. D., Rosa, A., Tretola, L., Toricco, R., Boiano, A., Catapano, P., Cavaliere, S., Volpicelli, A., et al. (2024) · Medicina · doi:10.3390/medicina60040575 · Cited by 94
Giordano, G. M., Pezzella, P., Mucci, A., Austin, S. F., Erfurth, A., Glenthoj, B. Y., Hofer, A., Hubeňák, J., Libiger, J., Melle, I. S., et al. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1333711 · Cited by 45
Mwangala, P. N., Makandi, M., Kerubo, A., Nyongesa, M. K., & Abubakar, A. A. (2024) · BJPsych Open · doi:10.1192/bjo.2024.55 · Cited by 31
Metadata
- Authors
- Schäfer, S. K., Thomas, L. M., Lindner, S., & Lieb, K.
- Affiliations
- Leibniz Institute for Resilience Research (DE)
- Johannes Gutenberg University Mainz (DE)
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2023-09-15
- Volume
- 22
- Issue
- 3
- Pages
- 449-462
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC10503931
- OpenAlex
- W4386765452
- Cited by
- 115
- References
- 54
- Citations by year
- 2026: 33 · 2025: 39 · 2024: 36 · 2023: 7
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- Problem Management Plus, transdiagnostic treatment, digital mental health interventions, distress, depression, anxiety, post-traumatic stress disorder, positive mental health, quality of life, social support, humanitarian crisis, World Health Organization
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
