Abstract summary 

Refugees and asylum seekers are at high risk of mental disorders due to various stressors before, during and after forceful displacement. The WHO Self-Help Plus (SH+) intervention was developed to manage psychological distress and a broad range of mental health symptoms in vulnerable populations. This study aimed to examine the effects and moderators of SH+ compared with Enhanced Care as Usual (ECAU) in reducing depressive symptoms among refugees and asylum seekers.Three randomised trials were identified with 1795 individual participant data (IPD). We performed an IPD meta-analysis to estimate the effects of SH+, primarily on depressive symptoms and second on post-traumatic stress, well-being, self-identified problems and functioning. Effects were also estimated at 5-6 months postrandomisation (midterm).There was no evidence of a difference between SH+ and ECAU+ in reducing depressive symptoms at postintervention. However, SH+ had significantly larger effects among participants who were not employed (β=1.60, 95% CI 0.20 to 3.00) and had lower mental well-being levels (β=0.02, 95% CI 0.001 to 0.05). At midterm, SH+ was significantly more effective than ECAU in improving depressive symptoms (β=-1.13, 95% CI -1.99 to -0.26), self-identified problems (β=-1.56, 95% CI -2.54 to -0.59) and well-being (β=6.22, 95% CI 1.60 to 10.90).Although SH+ did not differ significantly from ECAU in reducing symptoms of depression at postintervention, it did present benefits for particularly vulnerable participants (ie, unemployed and with lower mental well-being levels), and benefits were also evident at midterm follow-up. These results are promising for the use of SH+ in the management of depressive symptoms and improvement of well-being and self-identified problems among refugees and asylum seekers.

Authors & Co-authors:  Karyotaki Eirini E Sijbrandij Marit M Purgato Marianna M Acarturk Ceren C Lakin Daniel D Bailey Della D Peckham Emily E Uygun Ersin E Tedeschi Federico F Wancata Johannes J Augustinavicius Jura J Carswell Kenneth K Välimäki Maritta M van Ommeren Mark M Koesters Markus M Popa Mariana M Leku Marx Ronald MR Anttila Minna M Churchill Rachel R White Ross G RG Al-Hashimi Sarah S Lantta Tella T Au Teresa T Klein Thomas T Tol Wietse A WA Cuijpers Pim P Barbui Corrado C

Study Outcome 

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