Introduction: Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress. Objective: To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe. Methods: We conducted a randomized controlled trial in 5 European countries. Refugees and asylum seekers with psychological distress (General Health Questionnaire score ≥3), but without a Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or ICD/10 diagnosis of mental disorder, as assessed with the Mini International Neuropsychiatric Interview (MINI), were randomized to SH+ or enhanced treatment as usual (ETAU). The primary outcome was the frequency of mental disorders with the MINI at 6 months. Secondary outcomes included the frequency of mental disorders at postintervention, self-identified problems, psychological symptoms, and other outcomes. Results: Four hundred fifty-nine individuals were randomly assigned to SH+ or ETAU. For the primary outcome, we found no difference in the frequency of mental disorders at 6 months (Cramer V = 0.007, p = 0.90, RR = 0.96; 95% CI 0.52–1.78), while the difference significantly favored SH+ at after the intervention (secondary outcome, measured within 2 weeks from the last session; Cramer V = 0.13, p = 0.01, RR = 0.50; 95% CI 0.29–0.87). Conclusions: This is the first randomized indicated prevention study with the aim of preventing the onset of mental disorders in asylum seekers and refugees in Western Europe. As a prevention effect of SH+ was not observed at 6 months, but rather after the intervention only, modalities to maintain its beneficial effect in the long term need to be identified.
Psychother Psychosom

中文翻译：

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自助加法预防西欧难民和寻求庇护者精神障碍的有效性：一项多国随机对照试验

简介： Self-Help Plus (SH+) 是世界卫生组织为管理压力而开发的一种基于团体的心理干预。目的：评估 SH+ 在预防西欧难民和寻求庇护者精神障碍方面的有效性。方法：我们在 5 个欧洲国家进行了一项随机对照试验。有心理困扰的难民和寻求庇护者（一般健康问卷评分≥3），但没有《精神疾病诊断和统计手册》第 5 版 (DSM-5) 或 ICD/10 精神障碍诊断，经 Mini International Neuropsychiatric 评估访谈（MINI），被随机分配到 SH+ 或照常强化治疗（ETAU）。主要结果是 MINI 在 6 个月时出现精神障碍的频率。次要结果包括干预后精神障碍的频率、自我识别的问题、心理症状和其他结果。结果：459 人被随机分配到 SH+ 或 ETAU。对于主要结果，我们发现 6 个月时精神障碍的发生率没有差异（Cramer V = 0.007，p = 0.90，RR = 0.96；95% CI 0.52-1.78），而干预后差异显着有利于 SH+ （次要结果，在最后一次会议后 2 周内测量；Cramer V = 0.13，p = 0.01，RR = 0.50；95% CI 0.29–0.87）。结论：这是第一个旨在预防西欧寻求庇护者和难民精神障碍发作的随机指示预防研究。由于 SH+ 的预防效果在 6 个月时未观察到，而只是在干预之后，需要确定长期保持其有益效果的方式。
心理治疗师