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Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries
Annual Review of Clinical Psychology ( IF 18.4 ) Pub Date : 2017-05-08 00:00:00 , DOI: 10.1146/annurev-clinpsy-032816-045217
Daisy R. Singla 1, 2 , Brandon A. Kohrt 3 , Laura K. Murray 4 , Arpita Anand 5 , Bruce F. Chorpita 6 , Vikram Patel 5, 7, 8
Affiliation  

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.

中文翻译:


对世界的心理治疗:来自中低收入国家的经验教训

包括抑郁症,焦虑症和创伤后压力在内的常见精神障碍是导致世界范围内残疾的主要原因。在低收入和中等收入国家,对这些疾病的治疗受到限制。这项系统的综述综合了实施过程,并检验了中低收入国家非专业人员提供者对成年人常见精神障碍进行心理治疗的有效性。总共有27个试验符合资格标准;大多数疗法针对的是抑郁症或创伤后压力。通常由社区卫生工作者或初级保健或社区环境中的同伴提供治疗;通常在2到3个月内以单独的面对面形式进行少于10次的会议。治疗包括常见元素,例如非特定的参与和行为,人际交往,情感和认知元素的特定领域。合并效应量为0.49(95%置信区间= 0.36-0.62),有利于干预条件。我们的评论表明,心理治疗(包括一系列共同的要素,并由低成本,广泛可用的人力资源提供)在减轻常见精神障碍的负担方面具有中度至强效作用。

更新日期:2017-05-08
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