A meta-analysis on treatment efficacy of psychological interventions for mental disorders in individuals exposed to natural disasters

Ahlke Kip, Pauline Brouër, Nexhmedin Morina
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Abstract

Natural disasters and extreme weather events have increased in recent years and are likely to increase further in the face of climate change. Many survivors of such events suffer from mental health complaints. We conducted a systematic review and meta-analysis on treatment efficacy of psychological interventions for mental disorders in survivors of natural disasters. Systematic database searches resulted in the inclusion of ten randomised controlled trials with 613 participants (37.8 % women). Nine of these trials focused on posttraumatic stress disorder (PTSD), whereas one trial included individuals with alcohol dependence. Studies were conducted in China, Turkey, Iran, Pakistan, and Thailand. Four trials included children and adolescents who received group treatments, whereas six trials included adults who received individual treatments. Most interventions consisted of cognitive-behavioural therapy (k = 7). Results suggest a significant short-term efficacy of interventions for PTSD compared to passive control conditions (g = 1.44; 95 % CI 0.53–2.35, k = 7). The long-term efficacy after an average of 8 weeks post-treatment remained significant (g = 0.59; 95 % CI 0.25–0.93, k = 4). The trials furthermore yielded significant treatment effects regarding comorbid depression compared to control conditions for both short-term and long-term assessments. Heterogeneity in effect sizes between individual studies was small to moderate. Our findings suggest that psychological interventions, especially cognitive-behavioural therapy, can effectively treat PTSD and comorbid mental health problems in survivors of natural disasters. Nonetheless, conclusions are limited by the small number of trials and the strong focus on PTSD.

Abstract Image

对遭受自然灾害者精神障碍心理干预治疗效果的荟萃分析
近年来,自然灾害和极端天气事件有所增加,而且在气候变化的影响下可能会进一步增加。许多此类事件的幸存者都有心理健康问题。我们对自然灾害幸存者精神障碍心理干预的治疗效果进行了系统回顾和荟萃分析。通过系统性数据库搜索,我们纳入了 10 项随机对照试验,共有 613 名参与者(37.8% 为女性)。其中九项试验主要针对创伤后应激障碍(PTSD),一项试验则包括酒精依赖患者。研究分别在中国、土耳其、伊朗、巴基斯坦和泰国进行。四项试验包括接受集体治疗的儿童和青少年,六项试验包括接受个体治疗的成年人。大多数干预措施包括认知行为疗法(k = 7)。结果表明,与被动对照条件相比,创伤后应激障碍干预的短期疗效显著(g = 1.44;95 % CI 0.53-2.35,k = 7)。治疗后平均 8 周的长期疗效依然显著(g = 0.59;95 % CI 0.25-0.93,k = 4)。此外,在短期和长期评估中,与对照组相比,试验对合并抑郁症的治疗效果显著。各研究之间的效应大小存在小到中等程度的异质性。我们的研究结果表明,心理干预,尤其是认知行为疗法,可以有效治疗自然灾害幸存者的创伤后应激障碍和合并心理健康问题。尽管如此,由于试验数量较少且主要集中在创伤后应激障碍方面,因此得出的结论还存在一定的局限性。
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CiteScore
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