Treatment of children and adolescents with post-traumatic stress in humanitarian crises: systematic review and meta-analysis.

IF 8.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Bulletin of the World Health Organization Pub Date : 2025-07-01 Epub Date: 2025-05-27 DOI:10.2471/BLT.24.292608
Fiona E Douglas, Chirag Shroff, Richard Meiser-Stedman
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引用次数: 0

Abstract

Objective: To assess the effectiveness of mental health and psychosocial support interventions for addressing post-traumatic stress symptoms in children and adolescents in humanitarian settings, with separate analyses of targeted and universal interventions.

Methods: We systematically searched MEDLINE, Web of Science, PTSDpubs and PsycInfo databases for relevant randomized controlled trials that involved individuals aged 18 years or younger in humanitarian settings and compared psychological interventions with passive controls. Random-effects meta-analyses were performed separately for interventions targeted to specific symptoms and for more general universal interventions. The review was registered on PROSPERO (CRD42023434878).

Findings: The meta-analysis included 16 trials of targeted interventions (n = 2356) and 11 of universal interventions (n = 3378) that met inclusion criteria. Children and adolescents who received targeted interventions reported significantly fewer post-traumatic stress symptoms after the intervention than controls. These positive effects were sustained at follow-up. Benefits were also observed for depressive symptoms. In addition, universal interventions were associated with significantly fewer post-traumatic stress symptoms. Moderator analyses showed that outcomes were not significantly influenced by country income level, the use of lay or professional therapists, or whether trauma was caused by human-made or natural disasters. However, considerable heterogeneity and a high risk of bias were noted across studies.

Conclusion: Both targeted and universal mental health and psychosocial support interventions were associated with fewer post-traumatic stress symptoms among children and adolescents in humanitarian settings compared with passive controls. As interventions delivered by non-specialists were also successful, task-sharing could be considered where resources are scarce.

人道主义危机中患有创伤后应激的儿童和青少年的治疗:系统回顾和荟萃分析。
目的:评估心理健康和社会心理支持干预措施在人道主义环境中解决儿童和青少年创伤后应激症状方面的有效性,并对有针对性和普遍的干预措施进行单独分析。方法:系统地检索MEDLINE、Web of Science、ptsdbars和PsycInfo数据库中涉及18岁及以下人道主义环境的相关随机对照试验,并将心理干预与被动对照进行比较。随机效应荟萃分析分别针对针对特定症状的干预措施和更一般的普遍干预措施进行。该综述已在PROSPERO注册(CRD42023434878)。结果:荟萃分析包括符合纳入标准的16项针对性干预试验(n = 2356)和11项通用干预试验(n = 3378)。接受针对性干预的儿童和青少年在干预后报告的创伤后应激症状明显少于对照组。这些积极效果在随访中持续存在。对抑郁症状也有益处。此外,普遍干预与创伤后应激症状显著减少有关。调节分析显示,结果不受国家收入水平、非专业治疗师或专业治疗师的使用,以及创伤是由人为还是自然灾害造成的显著影响。然而,在研究中注意到相当大的异质性和高偏倚风险。结论:与被动对照相比,有针对性和普遍的心理健康和社会心理支持干预与人道主义环境中儿童和青少年创伤后应激症状的减少有关。由于非专业人员提供的干预措施也很成功,在资源匮乏的地方可以考虑分担任务。
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
Bulletin of the World Health Organization
Bulletin of the World Health Organization 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.50
自引率
0.90%
发文量
317
审稿时长
3 months
期刊介绍: The Bulletin of the World Health Organization Journal Overview: Leading public health journal Peer-reviewed monthly journal Special focus on developing countries Global scope and authority Top public and environmental health journal Impact factor of 6.818 (2018), according to Web of Science ranking Audience: Essential reading for public health decision-makers and researchers Provides blend of research, well-informed opinion, and news
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