Keyan Dharani, Dawson Katie S, Yadav Srishti, Azevedo Suzanna, Choi-Christou Jasmine, Maliakkal Deepthi J, Pillai Mohan K, Chokani Ritika, Thomas Elizabeth, George Tony S, Bryant Richard A
University of New South Wales, Sydney, NSW, Australia.
CHRIST (Deemed to be University), Bengaluru, Karnataka, India.
Eur J Psychotraumatol. 2025 Dec;16(1):2503603. doi: 10.1080/20008066.2025.2503603. Epub 2025 Jun 2.
Brief psychological interventions in low-and-middle-income-countries (LMICs) have been typically tested against usual or enhanced usual care (EUC). This design precludes understanding of the role of non-specific factors in influencing outcomes. This study evaluated an adapted version of WHO's Problem Management Plus (gPM+), titled against an active control condition to reduce anxiety and depression during the COVID-19 pandemic. In this two-arm, single-blind, randomised controlled trial, young adults aged 18-24 years who screened positive for COVID-19 related psychological distress in Bengaluru (India) were randomly allocated to either ( = 91) or non-directive Supportive Counselling (SC; = 92) groups. was a 6-sesion, group-based programme that taught coping strategies for stress. SC was a 6-sesion, group-based programme that offered non-directive support. The primary outcomes were anxiety and depression as measured by the Hospital Anxiety and Depression Scales (HADS) assessed at baseline, post-intervention, 2-months (primary outcome timepoint), and 6-months after treatment. Secondary outcomes included generalised worry, positive wellbeing, pandemic-related stress, and suicidal ideation. Between October 2021 and December 2022, 183 participants were enrolled into the trial. Relative to SC, did not lead to significant reductions in anxiety (mean difference 0.24 [95% CI, -1.01,1.48], >.05), or depression (mean difference .03 [95% CI, -1.19, 1.26], >.05). Similarly, there were no significant differences between conditions for all secondary outcomes. The findings suggest that the benefits of strategies that comprise transdiagnostic scalable psychological interventions may not surpass non-specific factors in driving symptom reduction. There is a need to further evaluate the role of non-specific factors in scalable psychological programmes because focusing on these may have implications for ease of training and implementation. Australian New Zealand Clinical Trials Registry identifier: ACTRN12621001064897.
中低收入国家（LMICs）的简短心理干预通常是与常规护理或强化常规护理（EUC）进行对照测试。这种设计妨碍了对非特异性因素在影响结果方面所起作用的理解。本研究评估了世界卫生组织的问题管理强化版（gPM+）的一个改编版本，名为“ ”，与一个积极对照条件进行对比，以减少新冠疫情期间的焦虑和抑郁。在这项双臂、单盲、随机对照试验中，在班加罗尔（印度）筛查出新冠相关心理困扰呈阳性的18至24岁年轻人被随机分配到“ ”组（n = 91）或非指导性支持咨询（SC；n = 92）组。“ ”是一个为期6节的基于小组的项目，教授应对压力的策略。SC是一个为期6节的基于小组的项目，提供非指导性支持。主要结局是通过医院焦虑和抑郁量表（HADS）在基线、干预后、2个月（主要结局时间点）和治疗后6个月进行评估的焦虑和抑郁。次要结局包括广泛性担忧、积极幸福感、疫情相关压力和自杀意念。在2021年10月至2022年12月期间，183名参与者被纳入试验。相对于SC，“ ”并没有导致焦虑（平均差异0.24 [95% CI，-1.01，1.48]，p>.05）或抑郁（平均差异0.03 [95% CI，-1.19，1.26]，p>.05）的显著降低。同样，所有次要结局在不同条件之间也没有显著差异。研究结果表明，包含跨诊断可扩展心理干预的策略在减轻症状方面的益处可能不会超过非特异性因素。有必要进一步评估非特异性因素在可扩展心理项目中的作用，因为关注这些因素可能对培训和实施的便利性有影响。澳大利亚新西兰临床试验注册标识符：ACTRN12621001064897。
