Study highlights effectiveness of behavioral interventions in conflict-affected regions

January 22, 2020

A new study, published in The Lancet Global Health, highlights the effectiveness of behavioural intervention in reducing psychological distress in conflict-affected regions.

More than 125 million people today are directly affected by armed conflict, the highest number since World War II. Although reported rates of mental disorders vary, previous studies have shown that mood and anxiety disorders are common, with high rates for depression and posttraumatic stress disorder. As such, scalable interventions to address a range of mental health problems are desperately needed.

Self-help Plus (SH+) is a guided self-help intervention developed by the World Health Organization (WHO) based on audio-recorded material and an illustrated workbook that can be facilitated by briefly trained non-specialists. It is delivered to groups of up to 30 people over 5 weekly sessions of 2 hours duration. As such, SH+ has been developed as a way of rapidly supporting large numbers of people experiencing psychological distress in the context of humanitarian crises.

Randomised controlled trial

To ascertain the effectiveness of SH+ a research team led by Dr Wietse Tol (Johns Hopkins University, US) and Dr Mark van Ommeren (WHO) conducted the first ever-randomised controlled trial of the intervention. The research team included the University of Liverpool's Dr Ross White (Reader of Clinical Psychology, Dept of Psychological Sciences). Dr White was one of the experts consulted by WHO in the development of the SH+ intervention which is based on Acceptance and Commitment Therapy.

The trial was conducted in Uganda, which hosts over 1.2 million refugees fleeing conflicts in countries such as neighbouring South Sudan and the Democratic Republic of Congo. The researchers visited 14 different villages in the area and recruited 20-30 female South Sudanese refugees from each village. A total of 694 female refugees with at least moderate levels of psychological distress were recruited into the study. Villages were randomly assigned to receive either SH+ or enhanced usual care. Participants were assessed 1 week before, 1 week after, and 3 months after the intervention.


The findings of this large randomised controlled trial indicated that SH+, compared to enhanced usual care, was effective at reducing psychological distress (as assessed by the Kessler 6 assessment instrument) and bringing about improvements on a range of other outcomes (including functioning, depression and wellbeing) 3 months after the intervention had stopped. The SH+ intervention was highly acceptable to participants with at least 80% of participants allocated to receive SH+ attending each of the five sessions.

Dr White, said: "Our research suggests that SH+ may be well suited as a first-line intervention for large populations exposed to major stressors in low-resource settings. SH+ will complement other intensive forms of intervention for those experiencing more severed difficulties.

"Further research is required to explore how the beneficial impact of SH+ can be maintained over longer periods of time."
The full study, entitled 'Guided Self-Help to Reduce Psychological Distress in South Sudanese Female Refugees in Uganda: A Cluster Randomized Trial', can be found here:

University of Liverpool

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to