Data from: Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: systematic review and meta-analysis

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future.

针对定居于高收入国家的难民与寻求庇护者的创伤后应激障碍（post-traumatic stress disorder, PTSD）治疗，存在诸多专属临床挑战。本项系统评价旨在考察社会心理干预针对该群体的临床有效性。我们检索了截至2016年7月的Cochrane随机对照试验中心注册库、CINAHL、EMBASE、PILOTS、PsycINFO、PubMed及Web of Science数据库。纳入研究为随机对照临床试验，对比了针对定居于高收入国家、罹患创伤后应激障碍的成年难民与寻求庇护者的社会心理干预与等候名单对照或常规治疗的干预效果。干预后的创伤后应激障碍症状为本次研究的主要结局指标。我们计算了标准化均数差（standardized mean differences, SMD）及95%置信区间（confidence intervals, CI）。本研究已在PROSPERO平台注册，注册编号为CRD42015027843。本次荟萃分析共纳入12项研究。相较于对照组，社会心理干预可有效减轻创伤后应激障碍症状（标准化均数差为-1.03，95%置信区间为-1.55至-0.51；需治疗人数为4.4；I²=86%，95%置信区间为77至91）。叙事暴露疗法——一种基于操作手册的创伤聚焦认知行为疗法（cognitive behavioural therapy, CBT）短期变体——是目前证据支持度最高的干预手段（纳入5项随机对照试验，共187名受试者，标准化均数差为-0.78，95%置信区间为-1.18至-0.38，I²=37%，95%置信区间为0至77）。纳入研究的方法学质量存在局限。总体而言，针对定居于高收入国家、罹患创伤后应激障碍的难民与寻求庇护者的社会心理干预，在减轻创伤后应激障碍症状方面可产生显著临床获益。但现有研究数量较少且方法学质量有限，未来应开展更为严谨的随机对照临床试验。