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Long-term efficacy of brief psychological treatments for common mental disorders in Myanmar refugees in Malaysia: 12-month follow-up of a randomized, active-controlled trial of integrative adapt therapy v. cognitive behavioral therapy

Published online by Cambridge University Press:  04 November 2022

Alvin Kuowei Tay Open the ORCID record for Alvin Kuowei Tay [Opens in a new window] ,
Mohammed Mohsin Open the ORCID record for Mohammed Mohsin [Opens in a new window] ,
Cheryl Yunn Shee Foo Open the ORCID record for Cheryl Yunn Shee Foo [Opens in a new window] ,
Susan Rees Open the ORCID record for Susan Rees [Opens in a new window]  and
Derrick Silove
Alvin Kuowei Tay*
Affiliation:
The Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine, Sydney, Australia
Mohammed Mohsin
Affiliation:
Mental Health Research Unit, Liverpool Hospital, Sydney, New South Wales, Australia
Cheryl Yunn Shee Foo
Affiliation:
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York City, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Susan Rees
Affiliation:
The Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine, Sydney, Australia
Derrick Silove
Affiliation:
The Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine, Sydney, Australia Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
*
Author for correspondence: Alvin Kuowei Tay, E-mail: alvin.tay@unsw.edu.au
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Abstract

Background

Long-term efficacy of brief psychotherapies for refugees in low-resource settings is insufficiently understood. Integrative adapt therapy (IAT) is a scalable treatment addressing refugee-specific psychosocial challenges.

Methods

We report 12-month post-treatment data from a single-blind, active-controlled trial (October 2017–August 2019) where 327 Myanmar refugees in Malaysia were assigned to either six sessions of IAT (n = 164) or cognitive behavioral treatment (CBT) (n = 163). Primary outcomes were posttraumatic stress disorder (PTSD), depression, anxiety, and persistent complex bereavement disorder (PCBD) symptom scores at treatment end and 12-month post-treatment. Secondary outcome was functional impairment.

Results

282 (86.2%) participants were retained at 12-month follow-up. For both groups, large treatment effects for common mental disorders (CMD) symptoms were maintained at 12-month post-treatment compared to baseline (d = 0.75–1.13). Although participants in IAT had greater symptom reductions and larger effect sizes than CBT participants for all CMDs at treatment end, there were no significant differences between treatment arms at 12-month post-treatment for PTSD [mean difference: −0.9, 95% CI (−2.5 to 0.6), p = 0.25], depression [mean difference: 0.1, 95% CI (−0.6 to 0.7), p = 0.89), anxiety [mean difference: −0.4, 95% CI (−1.4 to 0.6), p = 0.46], and PCBD [mean difference: −0.6, 95% CI (−3.1 to 1.9), p = 0.65]. CBT participants showed greater improvement in functioning than IAT participants at 12-month post-treatment [mean difference: −2.5, 95% CI (−4.7 to −0.3], p = 0.03]. No adverse effects were recorded for either therapy.

Conclusions

Both IAT and CBT showed sustained treatment gains for CMD symptoms amongst refugees over the 12-month period.

Keywords

Cognitive Behavioral Therapycommon mental disorderspsychosocial treatmentPTSDrefugee
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 13 , October 2023 , pp. 6055 - 6067
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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