Objective: In Arabic-speaking countries, most individuals with depression or obsessive–compulsive disorder (OCD) do not seek or receive evidence-based treatment due to a dearth of facilities, shame/self-stigma, or religious concerns. The feasibility and effectiveness of “Western” psychotherapeutic concepts have rarely been evaluated for Arabic-speaking populations. The present study examined the efficacy of My Metacognitive Training (myMCT), a trans-therapeutic self-help manual, in a mixed sample of participants with depression and/or OCD. We considered both participants with depression and/or OCD because a number of cognitive biases and dysfunctional beliefs are shared by the two disorders. Method: The myMCT manual was translated into Arabic. A total of 160 individuals with either self-reported OCD and/or self-reported depression were recruited. Individuals were assessed at baseline and then randomized either to myMCT (n = 84) or to a wait-list control condition (n = 76). Six weeks later, individuals were invited to the post assessment. The Beck Depression Inventory (BDI-II) served here as the primary outcome. Secondary outcomes were the Obsessive–Compulsive Inventory–Revised (OCI-R) and the self-rating version of the Yale-Brown Obsessive Compulsive Scale (OCD patients only). Individuals were reimbursed with a 17€ voucher. Results: Completion rates were similarly low in the two groups (myMCT: 37%, controls: 35%). Presumably because of the high rate of noncompletion and nonadherence (29%), the intention-to-treat analyses failed to yield a significant effect. Those who had at least started the myMCT intervention improved significantly on the BDI-II at a large effect size. A significantly larger improvement among those who had started or completed the myMCT intervention was also seen on the OCI-R at a large effect size. Conclusions: Individuals who studied the myMCT manual showed large improvement on the BDI-II, irrespective of their primary symptomatology. However, the results are seriously compromised by the low completion rates in both conditions. Importantly, evaluations using the same manual in other language populations (and with other background cultures) produced good to excellent retention rates. The study demonstrates that self-help manuals may not represent a suitable medium for large-scale dissemination of evidence-based self-help material in an Arab population and corroborates prior findings suggesting low adherence in this population. Whether smartphone apps and Internet interventions represent more viable alternatives than self-help manuals needs to be tested, as well as specific barriers preventing dissemination and completion in this population.

中文翻译：

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患有抑郁症和/或强迫症的阿拉伯语混合患者样本中元认知自助干预的接受和疗效：一项随机对照试验

目的：在说阿拉伯语的国家中，大多数抑郁症或强迫症患者由于设施匮乏，羞耻/自尊或宗教问题而没有寻求或接受循证治疗。对于讲阿拉伯语的人群，很少评估“西方”心理治疗概念的可行性和有效性。本研究在患有抑郁症和/或强迫症的参与者的混合样本中检查了我的元认知训练（myMCT）（一种跨治疗自助指南）的功效。我们考虑了患有抑郁症和/或强迫症的参与者，因为这两种疾病共有许多认知偏见和功能障碍性信念。方法：将myMCT手册翻译成阿拉伯语。总共招募了160名患有自我报告的强迫症和/或自我报告的抑郁症的人。在基线时对个体进行评估，然后将其随机分为myMCT（n = 84）或等待名单控制条件（n = 76）。六周后，邀请个人参加后期评估。贝克抑郁量表（BDI-II）是这里的主要结果。次要结局是强迫症量表（OCI-R）和耶鲁-布朗强迫症量表的自我评估版（仅针对OCD患者）。个人将获得17欧元的代金券。结果：两组的完成率同样较低（myMCT：37％，对照组：35％）。据推测，由于未完成和不遵守的比率很高（29％），意向性分析未能产生明显的效果。至少已开始进行myMCT干预的患者，对BDI-II的治疗效果显着改善。在开始或完成myMCT干预的患者中，在OCI-R上也观察到了明显更大的改善，并且效果很大。结论：研究myMCT手册的人员无论其主要症状如何，对BDI-II都有很大的改善。但是，两种情况下的完成率都低，严重损害了结果。重要的是，在其他语言人群（和其他背景文化）中使用同一手册进行的评估产生了很好的保留率。这项研究表明，自助手册可能并不适合作为在阿拉伯人口中大规模传播循证自助材料的适当媒介，并证实了表明该人群依从性较低的先前发现。