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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. © 2017 by Annual Reviews. All rights reserved.

Abstract

Developing Countries, Global Health, Humans, Mental Disorders, Mental Health, Psychotherapy, anxiety disorder, Article, behavior contracting, behavior therapy, biofeedback, cognitive behavioral therapy, communication skill, depression, goal attainment, health auxiliary, health care delivery, health care personnel, human, low income country, middle income country, motivational interviewing, neurofeedback, patient attitude, peer group, posttraumatic stress disorder, praise, primary medical care, psychoeducation, psychotherapy, randomized controlled trial (topic), role playing, social competence, suggestion, systematic review, therapy effect, treatment outcome, developing country, global health, mental disease, mental health, meta analysis, statistics and numerical data

Significance Statement:

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

Singla D.R., Kohrt B.A., Murray L.K., Anand A., Chorpita B.F., Patel V.

This research explores the adaptation and application of psychological treatments in low- and middle-income countries. It provides valuable lessons on culturally sensitive and resource-appropriate approaches to mental health care, which are crucial for addressing the global burden of mental health disorders in diverse settings.

Annual Review of Clinical Psychology

2017

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