Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: meta-analysis.

Abstract

<b>Background</b>The majority of survivors of mass violence live in low- and middle-income countries (LMICs).<b>Aims</b>To synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.<b>Method</b>Randomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21 812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.<b>Results</b>Twenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (<i>g</i> = 1.15) and a medium controlled effect size (<i>g</i> = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.<b>Conclusions</b>Psychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.