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Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries

2017; Annual Reviews; Volume: 13; Issue: 1 Linguagem: Inglês

10.1146/annurev-clinpsy-032816-045217

1548-5951

Daisy R. Singla, Brandon A. Kohrt, Laura K. Murray, Arpita Anand, Bruce F. Chorpita, Vikram Patel,

Maternal Mental Health During Pregnancy and Postpartum

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.