A systematic review on predictors of treatment outcome among forcibly displaced adults receiving psychological and/or psychosocial interventions

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-06-25 DOI:10.1016/j.cpr.2025.102619

Jennifer Kurath , Dharani Keyan , Aemal Akhtar , William Vilella Martins , Barbara Komenda , Victoria Maurer , Kadir Turgut , Richard A. Bryant , Naser Morina

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引用次数: 0

Abstract

Forcibly displaced people (FDP) have an elevated risk of mental disorders. Though existing interventions reduce psychological symptoms overall, many FDP do not respond, indicating a need to explore contributing factors. This systematic review examined predictors of treatment outcome among adult FDP receiving psychological and/or psychosocial interventions. Studies were included if they reported predictor analyses with positive or negative mental health outcomes. Records from five databases (MEDLINE, PsycINFO, PTSDpubs, Cochrane, Embase) and citations and bibliographies of 78 reviews, as well as of all included articles were evaluated (last update: 13.09.24). Risk of bias was assessed using Cochrane tools (RoB 2.0, ROBINS-I). Findings were synthesised using a narrative review, including a summary of effect estimates and an evaluation of evidence strength with an adapted version of the Best Evidence Synthesis Research Strategy (BESRS) framework for specialised and low-intensity interventions separately. Sixty-four studies (N = 9982, mean age = 38.0 years, 44.9 % females) reported 321 effects, of which 223 were summarised in 21 predictor categories. Most categories yielded insufficient evidence. For specialised interventions, pain, disability, lower level of education, unemployment, and longer time since arrival to the host country were associated with worse outcomes. For low-intensity interventions, a higher level of education and female gender were associated with better outcomes. Despite identifying key predictors, the high heterogeneity across studies and the large proportion of missing data warrant caution when interpreting results. Future research should ensure larger datasets and more complex models to detect consistent effects and shed light on the interplay between predictor variables. Clinicians should consider systematically assessing disability and pain at intake to provide additional support to the severely impaired.

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对接受心理和/或社会心理干预的被迫流离失所成年人治疗结果调节因子的系统回顾

被迫流离失所者（FDP）患精神障碍的风险较高。虽然现有的干预措施总体上减少了心理症状，但许多FDP没有反应，这表明需要探索促成因素。本系统综述检查了接受心理和/或社会心理干预的成年FDP治疗结果的调节因子。如果研究报告了具有积极或消极心理健康结果的调节分析，则纳入研究。评估了5个数据库（MEDLINE, PsycINFO, PTSDpubs, Cochrane, Embase）的记录和78篇综述的引文和参考书目，以及所有纳入的文章（最后更新：13.09.24）。使用Cochrane工具（rob2.0, ROBINS-I）评估偏倚风险。研究结果采用叙述性综述进行综合，包括对专门干预和低强度干预的效果估计的单独摘要。64项研究（N = 9982，平均年龄 = 38.0 岁，女性44.9 %）报告了321个调节效应，其中223个被总结为21个调节类别。大多数分类的证据不足。对于专门的干预措施，疼痛、残疾、低教育水平、失业和较长时间与较差的结果相关。对于低强度干预，较高的教育水平和女性性别与更好的结果相关。尽管确定了关键调节因子，但研究之间的高异质性和大量缺失数据需要在解释结果时谨慎。未来的研究应该确保更大的数据集和更复杂的模型来检测一致的调节效应，并阐明它们之间的相互作用。临床医生应该考虑系统地评估摄入时的残疾和疼痛，为严重受损的患者提供额外的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.