National Centre for Psychotraumatology, University of Southern Denmark, Denmark.
J Affect Disord. 2011 Jun;131(1-3):8-23. doi: 10.1016/j.jad.2010.07.005. Epub 2010 Aug 13.
Refugees with posttraumatic stress disorder (PTSD) often present with complicated traumatic symptoms, prolonged and repeated exposure to traumatic events, acculturation, and social problems. A consensus about suitability of psychosocial treatments for refugees does not exist. Never the less there is a need to review the state of knowledge about effective treatments for traumatized refugees, to help guide the practitioners in their choice of treatment methods.
A systematic review of treatment outcome studies was carried out.
Twenty-five studies were reviewed. The majority were treatment studies of different forms of cognitive-behavioral therapy (CBT). The rest were reports of outcomes of alternative treatments and a small group of studies of multidisciplinary treatments.
The amount of grey literature not covered by the review could not be estimated precisely. Included studies are methodologically diverse and consist of different refugee populations. This makes a broad interpretation of the treatment results only tentative.
Very large effect sizes were obtained in some of the CBT studies, indicating a broad suitability of CBT in the treatment of core symptoms of PTSD in adult refugees. Empirical evidence also points to the possibility that the maladaptive traumatic reactions in refugees can take shape of more complex reactions than those strictly specified in the diagnostic category of PTSD. Effectiveness of CBT treatments has as yet not been tested on the whole range of symptoms in these complex cases. There are few studies of treatments alternative to CBT and they are less methodologically rigorous than the CBT studies.
患有创伤后应激障碍（PTSD）的难民通常表现出复杂的创伤症状、创伤事件的长时间和反复暴露、文化适应和社会问题。对于心理社会治疗是否适合难民，目前尚未达成共识。尽管如此，仍有必要回顾关于有效治疗创伤难民的知识状况，以帮助指导从业者选择治疗方法。
对治疗结果研究进行了系统评价。
共审查了 25 项研究。其中大多数是不同形式的认知行为疗法（CBT）的治疗研究。其余的是替代治疗结果的报告，以及一小部分多学科治疗的研究。
无法准确估计未被审查涵盖的灰色文献量。所包括的研究在方法学上多种多样，包括不同的难民群体。这使得对治疗结果的广泛解释只是初步的。
一些 CBT 研究中获得了非常大的效应量，表明 CBT 在治疗成年难民的 PTSD 核心症状方面具有广泛的适用性。实证证据也表明，难民的适应不良的创伤反应可能呈现出比 PTSD 诊断类别中严格规定的更复杂的反应。CBT 治疗的有效性尚未在这些复杂病例的所有症状范围内进行测试。替代 CBT 的治疗方法研究较少，而且比 CBT 研究在方法学上更为严格。
