Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus
Open accessAbstract
Background The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited. Objective To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands. Methods We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019–December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat. Findings Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference −0.25; 95% CI −0.385 to −0.122; p=0.0001, Cohen’s d =0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen’s d =0.42), anxiety (p=0.001, Cohen’s d =0.27), PTSD symptoms (p=0.0005, Cohen’s d =0.39) and self-identified problems (p=0.03, Cohen’s d =0.26), but not on impairment (p=0.084, Cohen’s d =0.21). Conclusions PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit. Clinical implications Peer-provided psychological interventions should be considered for scale-up in HICs.
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
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?
In a trial in the Netherlands, PM+ for Syrian refugees produced 3-month effect sizes of d = 0.41 on HSCL-25 and d = 0.18 on WHODAS.
“At the 3 months follow-up the authors found effects of d = 0.41 on psychological distress (HSCL-25) and d = 0.18 on daily functioning (WHODAS), whereby the former was almost twice as high compared to our trial and the latter was comparable in size.”
From Effects of a self-guided digital mental health self-help intervention for Syrian refugees in Egypt: A pragmatic randomized controlled trial (2024) · cites this paper as [18]
The Results (Primary outcome) report a 3-month HSCL-25 effect of Cohen’s d=0.41. The Results (Secondary outcomes, table 2) report a 3-month WHODAS 2.0 effect of d=0.21, not d=0.18; that WHODAS result was not statistically significant (p=0.08). (LLM, conf=0.92)
Experimental — accuracy not yet measuredProblem Management Plus has been found effective in reducing psychological distress in Syrian refugees in the Netherlands.
“In previous randomized controlled trials (RCTs), PM + has been found to be effective in reducing psychological distress in low-income settings [28, 29] and Syrian refugees in the Netherlands [30, 31].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327 · see citing works
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770 · see citing works
Satinsky, E., Fuhr, D. C., Woodward, A., Sondorp, E., & Roberts, B. (2019) · Health Policy · doi:10.1016/j.healthpol.2019.02.007 · Cited by 539 · see citing works
Culturally centered psychosocial interventions
Bernal, G., & Sáez‐Santiago, E. (2006) · Journal of Community Psychology · doi:10.1002/jcop.20096 · Cited by 463 · see citing works
Dawson, K. S., Bryant, R. A., Harper, M., Kuowei Tay, A., Rahman, A., Schafer, A., & van Ommeren, M. (2015) · World Psychiatry · doi:10.1002/wps.20255 · Cited by 440 · see citing works
Self-citationTinghög, P., Malm, A., Arwidson, C., Sigvardsdotter, E., Lundin, A., & Saboonchi, F. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-018899 · Cited by 377 · see citing works
Bryant, R. A., Schafer, A., Dawson, K. S., Anjuri, D., Mulili, C., Ndogoni, L., Koyiet, P., Sijbrandij, M., Ulate, J., Harper Shehadeh, M., et al. (2017) · PLOS Medicine · doi:10.1371/journal.pmed.1002371 · Cited by 321 · see citing works
Self-citationLaban, C. J., Gernaat, H. B. P. E., Komproe, I. H., van der Tweel, I., & de Jong, J. T. V. M. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000188977.44657.1d · Cited by 308 · see citing works
Sijbrandij, M., Acartürk, C., Bird, M., Bryant, R. A., Burchert, S., Carswell, K., de Jong, J. T. V. M., Dinesen, C., Dawson, K. S., Chammay, R. E., et al. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1388102 · Cited by 298 · see citing works
Self-citationRahman, A., Hamdani, S. U., Awan, N. R., Bryant, R. A., Dawson, K. S., Khan, M. F., Azeemi, M. M.-U.-H., Akhtar, P., Nazir, H., Chiumento, A., et al. (2016) · JAMA · doi:10.1001/jama.2016.17165 · Cited by 292 · see citing works
Self-citationIbrahim, H., Ertl, V., Catani, C., Ismail, A. A., & Neuner, F. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1839-z · Cited by 277 · see citing works
Exposure therapy for PTSD: A meta-analysis
McLean, C. P., Levy, H. C., Miller, M. L., & Tolin, D. F. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102115 · Cited by 273 · see citing works
Schick, M., Zumwald, A., Knöpfli, B., Nickerson, A., Bryant, R. A., Schnyder, U., Müller, J., & Morina, N. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.28057 · Cited by 233 · see citing works
Self-citationA client‐generated psychometric instrument: The development of ‘PSYCHLOPS’
Ashworth, M. J., Shepherd, M. A., Christey, J., Matthews, V., Wright, K. P., Parmentier, H., Robinson, S. I., & Godfrey, E. L. (2004) · Counselling and Psychotherapy Research · doi:10.1080/14733140412331383913 · Cited by 191 · see citing works
Prevalence of mental disorders in refugees and asylum seekers: a systematic review and meta-analysis
Patanè, M., Ghane, S., Karyotaki, E., Cuijpers, P. J., Schoonmade, L. J., Tarsitani, L., & Sijbrandij, M. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.29 · Cited by 189 · see citing works
Self-citationRahman, A., Khan, M. N., Hamdani, S. U., Chiumento, A., Akhtar, P., Nazir, H., Nisar, A., Masood, A., Din, I. U., Khan, N. A., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32343-2 · Cited by 165 · see citing works
Self-citationPurgato, M., Carswell, K., Tedeschi, F., Acarturk, C., Anttila, M., Au, T., Bajbouj, M., Baumgartner, J., Biondi, M., Churchill, R., et al. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000517504 · Cited by 132 · see citing works
Self-citationAcartürk, C., Uygun, E., İlkkurşun, Z., Carswell, K., Tedeschi, F., Batu, M., Eskici, S., Kurt, G., Anttila, M., Au, T. M., et al. (2022) · World Psychiatry · doi:10.1002/wps.20939 · Cited by 129 · see citing works
Self-citationBryant, R. A., Bawaneh, A., Awwad, M., Al-Hayek, H., Giardinelli, L., Whitney, C., Jordans, M. J. D., Cuijpers, P., Sijbrandij, M., Ventevogel, P., et al. (2022) · PLoS Medicine · doi:10.1371/journal.pmed.1003949 · Cited by 123 · see citing works
Self-citationJordans, M. J. D., Kohrt, B. A., Sangraula, M., Turner, E. L., Wang, X., Shrestha, P., Ghimire, R., van’t Hof, E., Bryant, R. A., Dawson, K. S., et al. (2021) · PLOS Medicine · doi:10.1371/journal.pmed.1003621 · Cited by 120 · see citing works
Self-citationAcarturk, C., McGrath, M., Roberts, B., Ilkkursun, Z., Cuijpers, P., Sijbrandij, M., Sondorp, E., Ventevogel, P., McKee, M., Fuhr, D. C., et al. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-020-01941-6 · Cited by 115 · see citing works
Self-citationde Graaff, A. M., Cuijpers, P., McDaid, D., Park, A., Woodward, A., Bryant, R. A., Fuhr, D. C., Kieft, B., Minkenberg, E., & Sijbrandij, M. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020000724 · Cited by 109 · see citing works
Self-citationKaryotaki, E., Araya, R., Kessler, R. C., Waqas, A., Bhana, A., Rahman, A., Matsuzaka, C. T., Miguel, C., Lund, C., Garman, E. C., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.0301 · Cited by 67 · see citing works
Self-citationCuijpers, P., Quero, S., Papola, D., Cristea, I. A., & Karyotaki, E. (2021) · Psychological Medicine · doi:10.1017/s0033291719003581 · Cited by 62 · see citing works
Self-citationde Graaff, A. M., Cuijpers, P., Acarturk, C., Bryant, R., Burchert, S., Fuhr, D. C., Huizink, A. C., de Jong, J., Kieft, B., Knaevelsrud, C., et al. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1694347 · Cited by 57 · see citing works
Self-citationPlanning the scale up of brief psychological interventions using theory of change
Fuhr, D. C., Acartürk, C., Sijbrandij, M., Brown, F. L., Jordans, M. J. D., Woodward, A., McGrath, M., Sondorp, E., Ventevogel, P., Ikkursun, Z., et al. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-05677-6 · Cited by 56 · see citing works
Self-citationIntention-to-treat analysis when only a baseline value is available
Twisk, J. W. R., Rijnhart, J. J. M., Hoekstra, T., Schuster, N. A., ter Wee, M. M., & Heymans, M. W. (2020) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2020.100684 · Cited by 54 · see citing works
Self-citationDrescher, A., Kiselev, N., Akhtar, A., Acartürk, C., Bryant, R. A., İlkkurşun, Z., von Känel, R., Miller, K. E., Pfaltz, M. C., Schick, M., et al. (2021) · BMC Public Health · doi:10.1186/s12889-021-10498-1 · Cited by 44 · see citing works
Self-citation(2013) · Bristol Research (University of Bristol) · Cited by 42 · see citing works
Health Policy and Systems Responses to Forced Migration
Bozorgmehr, K., Roberts, B., Razum, O., et al. (2020) · Springer eBooks · doi:10.1007/978-3-030-33812-1 · Cited by 39 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Schäfer, S. K., Thomas, L. M., Lindner, S., & Lieb, K. (2023) · World Psychiatry · doi:10.1002/wps.21129 · Cited by 115 · see citing works
Mediavilla, R., Felez-Nobrega, M., McGreevy, K. R., Monistrol-Mula, A., Bravo-Ortiz, M.-F., Bayón, C., Giné-Vázquez, I., Villaescusa, R., Muñoz-Sanjosé, A., Aguilar-Ortiz, S., et al. (2023) · BMJ Mental Health · doi:10.1136/bmjment-2023-300697 · Cited by 47 · see citing works
Self-citationBurchert, S., Alkneme, M. S., Alsaod, A., Cuijpers, P., Heim, E., Hessling, J., Hosny, N., Sijbrandij, M., van’t Hof, E., Ventevogel, P., et al. (2024) · PLoS Medicine · doi:10.1371/journal.pmed.1004460 · Cited by 18 · see citing works
Self-citationRoos, R., Witteveen, A. B., Ayuso-Mateos, J. L., Barbui, C., Bryant, R. A., Felez-Nobrega, M., Figueiredo, N., Kalisch, R., Haro, J. M., McDaid, D., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05288-5 · Cited by 5 · see citing works
“In previous randomized controlled trials (RCTs), PM + has been found to be effective in reducing psychological distress in low-income settings [28, 29] and Syrian refugees in the Netherlands [30, 31].”
Self-citation
- Authors
- de Graaff, A. M., Cuijpers, P., Twisk, J. W. R., Kieft, B., Hunaidy, S., Elsawy, M., Gorgis, N., Bouman, T. K., Lommen, M. J. J., Acarturk, C., Bryant, R., Burchert, S., Dawson, K. S., Fuhr, D. C., Hansen, P., Jordans, M., Knaevelsrud, C., McDaid, D., Morina, N., Moergeli, H., Park, A.-L., Roberts, B., Ventevogel, P., Wiedemann, N., Woodward, A., & Sijbrandij, M.
- Affiliations
- Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Babeș-Bolyai University (RO)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Arq Psychotrauma Expert Group (NL)
- Amsterdam Public Health (NL)
- Parnassia Groep (NL)
- University of Groningen (NL)
- Department of Psychology, Koc Universitesi, Istanbul, Turkey
- UNSW Sydney (AU)
- Freie Universität Berlin (DE)
- University of Bremen (DE)
- International Federation of Red Cross and Red Crescent Societies (CH)
- War Child (NL)
- London School of Economics and Political Science (GB)
- University Hospital Zurich (CH)
- London School of Hygiene & Tropical Medicine (GB)
- Office of the United Nations High Commissioner for Refugees (CH)
- Royal Tropical Institute (NL)
- ORCID
- de Graaff, Anne M
- Cuijpers, Pim
- Twisk, Jos W R
- Elsawy, Mariam
- Bouman, Theo K
- Lommen, Miriam J J
- Acarturk, Ceren
- Bryant, Richard
- Burchert, Sebastian
- Dawson, Katie S
- Fuhr, Daniela C
- Hansen, Pernille
- Jordans, Mark
- Knaevelsrud, Christine
- McDaid, David
- Morina, Naser
- Moergeli, Hanspeter
- Park, A-La
- Roberts, Bayard
- Ventevogel, Peter
- Wiedemann, Nana
- Woodward, Aniek
- Sijbrandij, Marit
- Venue
- BMJ Mental Health
- Publisher
- BMJ
- Published
- 2023-02
- Volume
- 26
- Issue
- 1
- Pages
- e300637
- ISSN
- 2755-9734 (ISSN-L)
- PMC
- PMC10035776
- OpenAlex
- W4319595442
- Cited by
- 97
- References
- 30
- Citations by year
- 2026: 16 · 2025: 25 · 2024: 36 · 2023: 20
- FWCI
- 28.28
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- BMJ Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion, other-oa)
- Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- HighWire Press Open Archive (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver (cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- H2020 Society (733337)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- Problem Management Plus, Syrian refugees, common mental disorders, depression, anxiety, post-traumatic stress disorder, psychological distress, functional disability, refugee mental health
- MeSH terms
- Psychosocial Intervention, Adult, Depression, Female, Humans, Male, Refugees, Syria, Single-Blind Method
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
