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Meta‐analysis of interventions for posttraumatic stress disorder and depression in adult survivors of mass violence in low‐ and middle‐income countries
Author(s) -
Moriexhmedin,
Malek Mina,
Nickerson Angela,
Bryant Richard A.
Publication year - 2017
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22618
Subject(s) - depression (economics) , psychological intervention , randomized controlled trial , meta analysis , medicine , poison control , posttraumatic stress , psychiatry , injury prevention , suicide prevention , clinical psychology , environmental health , economics , macroeconomics
Background Most survivors of mass violence live in low‐ and middle‐income countries (LMICs). We conducted a meta‐analysis of randomized controlled psychotherapy trials for adult posttraumatic stress disorder (PTSD) and/or depression in LMICs. Methods We included 18 clinical trials (3,058 participants), in which 25 and 18 treatment arms measured symptoms of PTSD and depression, respectively. Results Active treatments for PTSD yielded a large aggregated pre–post effect size ( g = 1.29; 95% CI = [0.99; 1.59]) and a small to medium effect size at posttreatment when compared to control conditions ( g = 0.39; 95% CI = [0.24; 0.55]). Effect sizes were similar for pretreatment versus follow‐up ( g = 1.75; 95% CI = [1.17; 2.32]) and in comparison to waitlist at follow‐up ( g = 0.93; 95% CI = [0.56; 1.31]). Active treatments for depression produced large pre–post ( g = 1.28; 95% CI = [0.96; 1.61]) and controlled effect sizes (posttreatment, comparison to control conditions, g = 0.86; 95% CI = [0.54; 1.18]). Conclusions Our findings suggest that psychological interventions can effectively reduce symptoms of PTSD and depression in LMICs. Future research needs to focus on cost‐effective interventions that are likely to be disseminated to the large numbers of war survivors in LMICs.