基于认知行为疗法的简短心理干预措施对改善难民群体心理健康结局的效果:系统评价和荟萃分析。
Brief CBT-based psychological interventions to improve mental health outcomes in refugee populations: a systematic review and meta-analysis.
机构信息
Magdalen College, University of Oxford, Oxford, UK.
Medical Sciences Division, University of Oxford, Oxford, UK.
出版信息
Eur J Psychotraumatol. 2024;15(1):2389702. doi: 10.1080/20008066.2024.2389702. Epub 2024 Aug 30.
Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events. To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees. We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4. 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively. Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings' generalisability.
难民、寻求庇护者和国内流离失所者由于经历创伤和压力事件,心理健康问题负担沉重。本研究旨在总结现有证据,并分析短期(<3 个月)心理干预对改善心理健康结果的疗效,包括抑郁、焦虑和创伤后应激障碍(PTSD)相关症状。我们检索了 Medline、EMBASE、PsycINFO、CINAHL 和 Global Index Medicus 从建库至 2023 年 12 月 19 日的数据。我们纳入了使用任何认知行为疗法(CBT)或基于 CBT 的疗法的对照研究,这些疗法的治疗时间较短(<3 个月),并报告了干预前后的心理健康结果。我们使用随机效应进行荟萃分析,得出汇总的综合统计数据。使用 Cochrane 偏倚风险(RoB2)和 ROBINS-I 工具评估证据质量。本研究已在开放科学框架上注册,DOI 为 10.17605/OSF.IO/9CXU4。共检索到 37 篇文献中的 34 项符合条件的研究,其中 33 项研究(4479 名参与者)纳入荟萃分析。所有三个领域的即时心理健康结果均有总体改善,对 13 项焦虑结局研究(SMD-1.12,95%CI-1.72 至-0.52)、20 项抑郁结局研究(SMD-1.04,95%CI-1.97 至-0.11)和 24 项 PTSD 结局研究(SMD-0.82,95%CI-1.20 至-0.45)进行了分析。然而,在 3 至 6 个月的随访中,对心理健康结局的分析显示,与基线相比,没有显著变化,4 项研究的 SMD 为 0.24(95%CI-0.94 至 1.42),9 项研究的 SMD 为-0.73(95%CI-2.14 至 0.68),12 项研究的 SMD 为 0.29(95%CI-0.94 至 1.53),分别用于焦虑、抑郁和 PTSD。低质量证据表明,短期心理干预对难民和国内流离失所者的心理健康有积极的即时影响。然而,这些效果在短期随访中并不持久。异质性很高,即使在亚组中也是如此,这影响了我们研究结果的推广性。