Feature Review: Psychological therapies for the treatment of mental disorders in low- and middle-income countries affected by humanitarian crises

Findings indicate talking therapy may be beneficial but more higher-quality research evidence is needed, particularly for children and adolescents.

Adults and children and adolescents living in humanitarian contexts (such as in the aftermath of a crisis triggered by natural hazards) in low- and middle-income countries (LMICs) are exposed to multifaceted stressors that make them more vulnerable to developing post-traumatic stress disorder (PTSD), major depression, anxiety, and other negative psychological outcomes.

A recent review from Cochrane Common Mental Disorders included 33 trials with a total of 3523 participants that examined a range of psychological therapies.

They found that in adults, low-quality evidence shows greater benefit from psychological therapies than from control comparators in reducing (symptoms of) PTSD, major depression, and anxiety disorders. This evidence supports the approach of providing psychological therapies to populations affected by humanitarian crises, although we identified no studies that looked at the effectiveness or acceptability of psychological therapies for depressive and anxiety symptoms beyond six months. Only a small proportion of included trials reported data on children and adolescents, which provided very low-quality evidence of greater benefit derived from psychological treatments. With regard to acceptability, moderate- to low-quality evidence suggests no differences in dropout rates among adults and children and adolescents. Reviewers found no studies evaluating psychological treatments for (symptoms of) somatoform disorders or medically unexplained physical symptoms (MUPS) in adults, nor in children or adolescents, respectively.