- More than 125 million people today are directly affected by armed conflict and associated stress disorders.
- The study evaluated the effectiveness of a multicomponent behavioral intervention delivered in primary care centers in Peshawar, Pakistan.
- The intervention group was significantly lower on measures of anxiety and depression.
The study was conducted Atif Rahman, Ph.D., of the University of Liverpool, England, and colleagues.
‘Behavioral intervention has shown effectiveness in improvement across all dimensions of anxiety, depression, trauma-related symptoms, and functioning.’
AdvertisementThey evaluated the effectiveness of a multicomponent behavioral intervention delivered in primary care centers in Peshawar, Pakistan by lay health workers to adults with psychological distress.
The study published online by JAMA, is being released to coincide with its presentation at the International Society for Traumatic Stress Studies annual meeting. More than 125 million people today are directly affected by armed conflict, the highest number since World War II.
A meta-analysis of a subset of relatively rigorous post-conflict surveys showed that mood and anxiety disorders were common, with rates of 17 %t for depression and 15% for post-traumatic stress disorder (PTSD).
Scalable interventions to address a range of mental health problems are needed.
In this study, 346 adult primary care attendees with high levels of both psychological distress and functional impairment were recruited.
The trial was conducted from November 2014 through January 2016 in 3 primary care centers in Peshawar, Pakistan.
Participants were randomly assigned to receive a five weekly 90-minute individual sessions.
Sessions were administered by lay health workers, that included empirically supported intervention strategies of problem solving, behavioral activation, strengthening social support, and stress management (n = 172); or enhanced usual care (n= 174).
Among the patients, 146 (intervention) and 160 (enhanced usual care) completed the study.
After 3 months of treatment, the intervention group had significantly lower average scores than the control group on measures of anxiety and depression.
At 3 months, there were also significant differences in scores of post-traumatic stress, functional impairment and symptoms of depressive disorder.
"This randomized clinical trial tested the effectiveness of a brief lay health worker-administered multicomponent intervention in Peshawar, Pakistan, a low-income setting affected by ongoing conflict and insecurity," the authors write.
Improvement across all dimensions of anxiety, depression, trauma-related symptoms, and functioning demonstrated the effectiveness of the transdiagnostic feature of the intervention.
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