Psychological Interventions for PTSD, Depression, and Anxiety in Child, Adolescent and Adult Forced Migrants: A Systematic Review and Frequentist and Bayesian Meta-Analyses

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-08-16 DOI:10.1002/cpp.3042

Marc Molendijk, Charlotte Baart, Jan Schaffeld, Zeynep Akçakaya, Charlotte Rönnau, Marike Kooistra, Rianne de Kleine, Celina Strater, Louise Mooshammer

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Abstract

Objective

The number of forced migrants has been rising for years. Many forced migrants suffer from post-traumatic stress disorder (PTSD), depression, and/or anxiety and need treatment. Here, we evaluate the effectiveness of psychological interventions (CBT, EMDR, expressive/art, mindfulness, mixed elements, NET and psychoeducation) in reducing symptoms of PTSD, depression, and anxiety in forced migrants.

Design and Data Sources

Systematic searches in PubMed and Web of Science and searches of preprint servers and grey literature were performed (final search date: 1 September 2023). Random-effects frequentist and Bayesian meta-analyses were used for data synthesis.

Results

We included 84 studies on treatment effects in adults (pooled N = 6302) and 32 on children and adolescents (pooled N = 1097). Our data show a reduction in symptoms of PTSD, depression and anxiety symptoms in both adults and child/adolescent forced migrants. Pooled pre- to post-treatment effects (effect size Cohen's d) ranged from −1.03 to −0.26 for PTSD, from −0.91 to −0.11 for depression and from −0.91 to −0.60 for anxiety, without there being differences in outcome per study design (i.e., RCT comparison vs. non-RCT comparison vs. single arm treatment study). Treatment effects remained evident over follow-up, and not a single type of treatment stood out as being superior to other treatment types. Structural differences in populations (e.g., regarding country of origin) over studies, however, could have hampered the validity of the comparisons between study characteristics such as treatment type.

Conclusion

Our findings support the effectiveness of psychological treatment in adult and child/adolescent forced migrants.

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儿童、青少年和成年被迫移民创伤后应激障碍、抑郁和焦虑的心理干预：系统综述及频数和贝叶斯元分析

目标多年来，被迫移民的人数一直在增加。许多被迫移民患有创伤后应激障碍（PTSD）、抑郁症和/或焦虑症，需要接受治疗。在此，我们评估了心理干预（CBT、EMDR、表达/艺术、正念、混合元素、NET 和心理教育）在减少被迫移民创伤后应激障碍、抑郁和焦虑症状方面的有效性。设计与数据来源在 PubMed 和 Web of Science 上进行了系统搜索，并搜索了预印本服务器和灰色文献（最终搜索日期：2023 年 9 月 1 日）。数据综合采用随机效应频数分析和贝叶斯荟萃分析。结果我们纳入了 84 项关于成人治疗效果的研究（汇总样本数 = 6302）和 32 项关于儿童和青少年治疗效果的研究（汇总样本数 = 1097）。我们的数据显示，成人和儿童/青少年被迫移民的创伤后应激障碍、抑郁和焦虑症状均有所减轻。从治疗前到治疗后的综合效应（效应大小 Cohen's d）分别为：创伤后应激障碍-1.03 至 -0.26，抑郁症-0.91 至 -0.11，焦虑症-0.91 至 -0.60。治疗效果在随访期间依然明显，没有一种治疗方法优于其他治疗方法。然而，不同研究中人群的结构差异（如原籍国）可能会影响治疗类型等研究特征之间比较的有效性。结论我们的研究结果支持对成人和儿童/青少年被迫移民进行心理治疗的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.