Lawton Katie, Spencer Angela
St Helens and Knowsley Teaching Hospitals NHS Trust, 474, Kings Road, Stretford, Manchester, M32 8QW, UK.
University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
J Immigr Minor Health. 2021 Jun;23(3):624-639. doi: 10.1007/s10903-021-01151-5. Epub 2021 Feb 15.
Global conflict in 2019 created record numbers of displaced children. These children have experienced multiple traumas and subsequently suffer high levels of mental health symptoms. Cognitive-behavioural therapy (CBT) is commonly used for post-traumatic stress disorder (PTSD), depression and anxiety, however the current evidence-base of CBT in child refugees is sparse, with mixed results. This study aimed to assess the effects of CBT on symptoms of PTSD, depression and anxiety in child refugees/AS. Ethics were reviewed and granted by the University of Manchester ethics committee. Medline, Embase, Cochrane, PsycINFO and CINAHL were systematically searched. Studies were included if CBT was delivered to refugee/AS children with pre and post-intervention measures of symptoms. Sixteen studies fulfilled criteria. In all studies, mental health symptom scores post-intervention had reduced, suggesting an improvement in mental health following CBT. This reduction was statistically significant in twelve studies (p < 0.001-0.5), clinically significant in eight studies and maintained at follow-up periods. No adverse effects of CBT were identified. This is the first systematic review to focus solely on CBT in child refugee populations, with unanimously positive results. Its use is cautiously recommended, however the need for more methodologically rigorous studies in this population is highlighted.
2019年的全球冲突导致流离失所儿童数量创下纪录。这些儿童经历了多重创伤，随后出现了高水平的心理健康症状。认知行为疗法（CBT）常用于治疗创伤后应激障碍（PTSD）、抑郁症和焦虑症，然而目前关于CBT在儿童难民中的证据基础较为薄弱，结果也参差不齐。本研究旨在评估CBT对儿童难民/寻求庇护者创伤后应激障碍、抑郁和焦虑症状的影响。该研究经过了曼彻斯特大学伦理委员会的伦理审查并获得批准。对Medline、Embase、Cochrane、PsycINFO和CINAHL进行了系统检索。如果对难民/寻求庇护儿童实施了CBT并对干预前后的症状进行了测量，则纳入相关研究。共有16项研究符合标准。在所有研究中，干预后心理健康症状评分均有所降低，表明CBT后心理健康状况有所改善。在12项研究中，这种降低具有统计学意义（p<0.001-0.5），在8项研究中具有临床意义，且在随访期内保持不变。未发现CBT有不良反应。这是第一项专门关注儿童难民群体中CBT的系统评价，结果一致呈阳性。然而，鉴于该群体需要开展更多方法学严谨的研究，故谨慎推荐使用CBT。
