TY - JOUR
T1 - Psychological Treatments for the World
T2 - Lessons from Low- and Middle-Income Countries
AU - Singla, Daisy R.
AU - Kohrt, Brandon A.
AU - Murray, Laura K.
AU - Anand, Arpita
AU - Chorpita, Bruce F.
AU - Patel, Vikram
N1 - Funding Information:
D.R.S. and B.A.K. were supported by National Institute of Mental Health grants U19MH095687 (D.R.S.) and K01MH104310 (B.A.K.). V.P. was supported by a Wellcome Trust Principal Research Fellowship (106919/Z/15). Finally, we appreciate the responses of the trial authors who completed the online survey and contributed data to this systematic review.
Publisher Copyright:
© 2017 by Annual Reviews. All rights reserved.
PY - 2017/5/8
Y1 - 2017/5/8
N2 - Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.
AB - Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.
KW - Common elements
KW - Global mental health
KW - Implementation processes
KW - Low- and middle-income countries
KW - Meta-analysis
KW - Psychological treatments
KW - Systematic review
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U2 - 10.1146/annurev-clinpsy-032816-045217
DO - 10.1146/annurev-clinpsy-032816-045217
M3 - Article
C2 - 28482687
AN - SCOPUS:85019061124
SN - 1548-5943
VL - 13
SP - 149
EP - 181
JO - Annual Review of Clinical Psychology
JF - Annual Review of Clinical Psychology
ER -