Alzaghoul Aseel F, McKinlay Alison R, Archer Marc
Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, UK.
BJPsych Open. 2022 Aug 8;8(5):e153. doi: 10.1192/bjo.2022.552.
Millions of children and adolescents are exposed to wars, affecting their psychological well-being. This review focuses on psychosocial interventions in low and middle-income countries (LMICs) in the Middle East, where mental health services are limited.
Our primary aim was to evaluate the effectiveness of trial-assessed psychosocial interventions in reducing post-traumatic stress disorder (PTSD) symptoms in children and adolescents aged ≤18 years who were exposed to war in LMICs in the Middle East. Changes in other psychological conditions and symptoms were evaluated where reported.
PubMed, Cochrane Library and Ovid were searched without year restriction, in December 2021. Previous review reference lists were also checked. Only studies published in English were included. Each study was evaluated for risk of bias and results are presented as a narrative synthesis.
Three group-based interventions were identified and evaluated across six studies: 'Teaching Recovery Techniques', 'Writing for Recovery' and 'Advancing Adolescents'. Two studies took place in post-war settings, and four in a context of ongoing conflict. Positive experiences and improved social skills were indicated following most interventions, but Teaching Recovery Techniques was the only programme associated with a statistically significant reduction in PTSD score. Differences in follow-up interval limited comparability of outcomes.
This review highlights a paucity of evidence for effective treatment options for children and adolescents affected by war from LMICs in the Middle East. Promising indications of reductions in PTSD symptoms, specifically from Teaching Recovery Techniques, require further rigorous evaluation and long-term follow-up.
数以百万计的儿童和青少年遭受战争影响，这对他们的心理健康造成了冲击。本综述聚焦于中东地区低收入和中等收入国家（LMICs）的社会心理干预措施，该地区的心理健康服务有限。
我们的主要目的是评估经试验评估的社会心理干预措施对中东地区LMICs中遭受战争影响的18岁及以下儿童和青少年创伤后应激障碍（PTSD）症状的减轻效果。如有报道，还评估了其他心理状况和症状的变化。
于2021年12月对PubMed、Cochrane图书馆和Ovid进行了无年份限制的检索。还检查了之前综述的参考文献列表。仅纳入以英文发表的研究。对每项研究进行偏倚风险评估，结果以叙述性综述形式呈现。
在六项研究中确定并评估了三种基于群体的干预措施：“教学康复技巧”、“写作康复”和“促进青少年发展”。两项研究在战后环境中开展，四项研究在持续冲突的背景下进行。大多数干预措施后都显示出积极体验和社交技能的改善，但“教学康复技巧”是唯一与PTSD评分在统计学上显著降低相关的项目。随访间隔的差异限制了结果的可比性。
本综述凸显了中东地区LMICs中受战争影响的儿童和青少年有效治疗方案的证据匮乏。PTSD症状减轻的有前景迹象，特别是“教学康复技巧”带来的效果，需要进一步严格评估和长期随访。
