Effectiveness of group problem management plus in distressed Syrian refugees in Turkiye: a randomized controlled trial

Basit Öğe Kaydı
dc.authorid0000-0001-7093-1554
dc.authorid0000-0001-5430-9810
dc.authorid0000-0002-4704-4874
dc.authorid0000-0002-9607-819X
dc.authorid0000-0001-6691-1809
dc.authorid0000-0003-0744-2664
dc.authorid0000-0001-5497-2743
dc.contributor.authorAcarturk, C.
dc.contributor.authorKurt, G.
dc.contributor.authorIlkkursun, Z.
dc.contributor.authorde Graaff, A. M.
dc.contributor.authorBryant, R.
dc.contributor.authorCuijpers, P.
dc.contributor.authorUygun, E.
dc.date.accessioned2026-04-04T18:55:37Z
dc.date.available2026-04-04T18:55:37Z
dc.date.issued2024
dc.departmentİstanbul Bilgi Üniversitesi
dc.description.abstractAims. Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, T & uuml;rkiye. Methods. A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles). Results. Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, p = 0.045, d = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference -0.17, 95 % CI -0.32, -0.02, p = 0.028, d = 0.27) and anxiety (adjusted mean difference -0.21, 95 % CI -0.37, -0.05, p = 0.009, d = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference -1.98, 95 % CI -3.93, -0.02, p = 0.048, d = 0.26). Conclusion. In this study in an urban setting in T & uuml;rkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.
dc.description.sponsorshipHorizon 2020 Framework Programme for Research and Innovation (2014-2020)
dc.description.sponsorshipHorizon 2020 Framework Programme for Research and Innovation (2014-2020)
dc.identifier.doi10.1017/S2045796024000453
dc.identifier.doi10.1017/S2045796024000453
dc.identifier.issn2045-7960
dc.identifier.issn2045-7979
dc.identifier.pmid39344836
dc.identifier.scopus2-s2.0-85205335980
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1017/S2045796024000453
dc.identifier.urihttps://hdl.handle.net/11411/10492
dc.identifier.volume33
dc.identifier.wosWOS:001325921800001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherCambridge Univ Press
dc.relation.ispartofEpidemiology and Psychiatric Sciences
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260402
dc.snmzKA_Scopus_20260402
dc.subjectAnxiety
dc.subjectDepression
dc.subjectPsychological Intervention
dc.subjectRefugees
dc.subjectRandomized Controlled Trial
dc.titleEffectiveness of group problem management plus in distressed Syrian refugees in Turkiye: a randomized controlled trial
dc.typeArticle

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