Effectiveness of the psychological interventions on depression, anxiety and somatization in the migrants

Journal title RICERCHE DI PSICOLOGIA
Author/s Edvaldo Begotaraj, Catia De Paola, Daniela Sambucini, Chiara Ciacchella, Emanuele Caroppo, Carlo Lai
Publishing Year 2020 Issue 2020/1
Language Italian Pages 16 P. 259-274 File size 220 KB
DOI 10.3280/RIP2020-001012
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

The massive forced migration is a phenomenon that has raised socio-economic questions in the last years respect to the problems of the flowes containment and social and employment integration of the emigrants in the countries destination. The causes of the forced migration are originated from the poverty, war conflicts, tortures, persecutions different types of violence happening at the country of provenience, growing up between rich and poor and in the public debts which wipes the economic wealth of some nations. This aspects impact on migrants health leave indelible sequelae. In the last years, indeed, the scientific landscape has extended the focus of interest on psychological aspect of the migrant. The traumatic experiences suffered by the migrants can be observed in 3 moments: before, during and after the migration traveling. These experiences cause typical and distinctive psychological sequelae, same as depression, anxiety and somatization as the much more relevant symptomology. Therefore, the necessity to promote the psychological wellness of the migrants in the host country arises in the recent years. The aim of the review was to assessed the efficacy of the main psychological treatments applied to the migrants through a thoroughly and qualitative analyses of the literature. The preliminary collection of data was focused on studies that provided psychological interventions with a pre-treatment and post-treatment assessment at least of the depression, anxiety and somatization. The selection included studies of the three kinds: randomized-controlled design, almost experimental, observative. The review was conducted including 52 studies. The psychological interventions have been classified in 5 categories of treatment (cognitive-behavioural therapy, narrative exposure therapy, dynamic therapy, combined psychological treatments, psychological treatments combined with pharmacological treatments). There were calculated the significative and non-significative results for each category of treatment referring to each outcome: depression, anxiety and somatization. The qualitative results of the review showed that the cognitive-behavioural therapy had a significative effect on the depression at 61% of the cases, on anxiety at 50% of the cases, and had no effects on the somatization. The narrative exposure therapy had significative effects on the depression at 57% of the cases), it had effects on somatization at 50% of the cases and had no effects on anxiety. The dynamic therapy had significative effects on the depression at 50% of the cases, on the anxiety at 50% of the cases, and the same size effect on somatization at 50%. The combined psychological treatments had a significative effect over the depression at 46% of cases and had a significative effect over the anxiety and somatization, both at 60% of cases. The psychological treatments combined with pharmacological treatments had a significative effect over the depression at 61% of cases, over the anxiety at 36% of cases and over the somatization at 39% of cases. Therefore, the qualitative observation showed the probability to have a significative effect post-treatment over the anxiety lower than 50% comparing to somatization. Specifically, concerning the individual treatments, the effects of the cognitive-behavioural therapy on the anxiety seemed to be due to the fortuity. At the same time, it seemed to influence the somatization, indeed the effect is verified on the depression. Regarding the narrative exposure therapy, the probability to verify a significative effect on the depression is caused by the fortuity, same as for the dynamic therapy and for the combined psychological treatments. Also, it seemed to cause no effect on depression and anxiety. Lastly, concerning the psychological treatments combined with pharmacological treatments, there were find significative effects of efficacy on the depression, but no effects on anxiety and somatization.

Keywords: Migration, psychological interventions, depression, anxiety, somatization.

  1. Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Cuijpers, P., & Aker, T. (2015). EMDR for Syrian Refugees with posttraumatic stress disorder symptoms: Results of a pilot randomized controlled trial. European Journal of Psychotraumatology, 6(1), 27414.
  2. Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Gulen, B., &
  3. Cuijpers, P. (2016). The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depressione among Syrian Rifugees: Results of a randomized controlled trial. Psychological medicine, 46(12), 2583-2593.
  4. (2011). NET for PTSD increases top-down processing of aversive stimuli-evidence from a randomized controlled treatment trial. BMC neuroscience, 12(1), 127. DOI: 10.1186/1471-2202-12-127
  5. Arntz, A., Sofi, D., & van Breukelen, G. (2013). Imagery Rescripting as treatment for complicated PTSD in Rifugees: A multiple baseline case series study. Behaviour Research and Therapy, 51(6), 274-283.
  6. Begotaraj, E., (2018-2019). Il viaggio migratorio e le conseguenze psicologiche. Tesi di dottorato, Sapienza Universita di Roma. Relatore C. Lai. Bettin, G., & Cela, E. (2014). L’evoluzione storica dei flussi migratori in Europa e in Italia. Rapporto di Ricerca realizzato nell’ambito del progetto PRIN “Piccoli comuni e coesione sociale: politiche e pratiche urbane per l’inclusione sociale e spaziale degli immigrati”, Venezia.
  7. Boehnlein, J. K., Kinzie, J. D., Sekiya, U., Riley, C., Pou, K., & Rosborough, B. (2004). A ten-year treatment outcome study of traumatized Cambodian Rifugees. The Journal of nervous and mental disease, 192(10), 658-663.
  8. Brune, M., Jose Eiroa-Orosa, F., Fischer-Ortman, J., & Haasen, C. (2014). Effectiveness of psychotherapy for traumatized Rifugees without a secure residency status. International Journal of Migration, Health and Social Care, 10(1), 52-59. DOI: 10.1108/IJMHSC-07-2013-0022
  9. Buhmann, C. B., Nordentoft, M., Ekstroem, M., Carlsson, J., & Mortensen, E. L. (2016). The effect of flexible cognitive–behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised Rifugees: pragmatic randomised controlled clinical t r i a l . The British Journal of Psychiatry, 208(3), 252-259.
  10. Carlsson, J. M., Olsen, D. R., Kastrup, M., & Mortensen, E. L. (2010). Late mental health changes in tortured Rifugees in multidisciplinary treatment. The Journal of nervous and mental disease, 198(11), 824-828.
  11. Carlsson, J., Sonne, C., Vindbjerg, E., & Mortensen, E. L. (2018). Stress management versus cognitive restructuring in trauma-affected Rifugees pragmatic randomised study. Psychiatry research,266, 116-123.
  12. Conti, G. (2019). Migrazioni di massa: armi non convenzionali di coercizione. D’Ardenne, P., Ruaro, L., Cestari, L., Fakhoury, W., & Priebe, S. (2007). Does interpreter-mediated CBT with traumatized refugee people work? A comparison of patient outcomes in East London. Behavioural and Cognitive Psychotherapy, 35(3), 293-301. DOI: 10.1017/S1352465807003645
  13. Drozdek, B. (1997). Follow-up study of concentration camp survivors from Bosnia-Herzegovina: three years later. The Journal of nervous and mental disease, 185(11), 690-694.
  14. Drožđek, B., & Bolwerk, N. (2010). Evaluation of group therapy with traumatized Asylum seekers and Refugees. The Den Bosch Model. Traumatology, 16(4), 117-127. DOI: 10.1097/00005053-199711000-00007
  15. Droždek, B., Kamperman, A. M., Bolwerk, N., Tol, W. A., & Kleber, R. J. (2012). Group therapy with male Asylum seekers and Refugees with posttraumatic stress disorder: A controlled comparison cohort study of three day-treatment programs. The Journal of nervous and mental disease, 200(9), 758-765.
  16. Drožđek, B., Kamperman, A. M., Tol, W. A., Knipscheer, J. W., & Kleber, R. J. (2014). Seven- year follow- up study of symptoms in Asilum seekers and Refugees with PTSD treated with trauma- focused groups. Journal of clinical psychology, 70(4), 376-387.
  17. Folkes, C. E. (2002). Thought Field Therapy and trauma recovery. mental health, 4(2).
  18. Halvorsen, J. O., & Stenmark, H. (2010). Narrative exposure therapy for posttraumatic stress disorder in tortured Refugees: A preliminary uncontrolled trial. Scandinavian journal of psychology, 51(6), 495-502.
  19. Hensel-Dittmann, D., Schauer, M., Ruf, M., Catani, C., Odenwald, M., Elbert, T., & Neuner, F. (2011). Treatment of traumatized victims of war and torture: a randomized controlled comparison of NET and stress inoculation training. Psychotherapy and psychosomatics, 80( 6 ) , 3 4 5 - 3 5 2 . DOI: 10.1159/000327253
  20. Hijazi, A. M., Lumley, M. A., Ziadni, M. S., Haddad, L., Rapport, L. J., & ArTENz, B. B. (2014). Brief NET for posttraumatic stress in Iraqi Refugees: A preliminary randomized clinical trial. Journal of traumatic stress, 27(3), 314-322.
  21. Hinton, D. E., Pham, T., Tran, M., Safren, S. A., Otto, M. W., & Pollack, M. H. (2004). CBT for Vietnamese Refugees with treatment- resistant PTSD and panic attacks: A pilot study. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 17(5), 429-433.
  22. Hinton, D. E., Chhean, D., Pich, V., Safren, S. A., Hofmann, S. G., & Pollack, M. H. (2005). A randomized controlled trial of cognitive- behavior therapy for Cambodian Refugees with treatment- resistant PTSD and panic attacks: A cross- over design. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 18(6), 617-629.
  23. Hinton, D. E., Rivera, E. I., Hofmann, S. G., Barlow, D. H., & Otto, M. W. (2009). Adapting CBT for traumatized Refugees and ethnic minority patients: Examples from culturally adapted CBT (CA-CBT). Transcultural psychiatry, 49(2), 340-365.
  24. Kruse, J., Joksimovic, L., Cavka, M., Woller, W., & Schmitz, N. (2009). Effects of trauma- focused psychotherapy upon war Refugees. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 22(6), 585-592.
  25. Lely, J. C., Smid, G. E., Jongedijk, R. A., W. Knipscheer, J., & Kleber, R. J. (2019). The effectiveness of NET: a review, meta-analysis and meta-regression analysis. European journal of psychotraumatology, 10(1), 1550344. DOI: 10.1080/20008198.2018.1550344
  26. Mahoney, A., Karatzias, T., & Hutton, P. (2019). A systematic review and metaanalysis of group treatments for adults with symptoms associated with complex post-traumatic stress disorder. Journal of affective disorders, 243, 305- 321. DOI 10.1016/j.jad.2018.09.059.
  27. Meffert, S. M., Abdo, A. O., Alla, O. A. A., Elmakki, Y. O. M., Omer, A. A., Yousif, S., ... & Marmar, C. R. (2014). A pilot randomized controlled trial of interpersonal psychotherapy for Sudanese Refugees in Cairo, Egypt. Psychological Trauma: Theory, Research, Practice, and Policy, 6(3), 240.
  28. Morina, N., Maier, T., Bryant, R., Knaevelsrud, C., Wittmann, L., Rufer, M., ... & Muller, J. (2012). Combining biofeedback and Narrative exposure therapy for persistent pain and PTSD in Refugees: a pilot study. European journal of psychotraumatology, 3(1), 17660.
  29. Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of NET, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an african refugee settlement. Journal of consulting and clinical psychology, 72( 4 ) , 5 7 9 . DOI : 10.1037/0022-006X.72.4.579.
  30. Neuner, F., Onyut, P. L., Ertl, V., Odenwald, M., Schauer, E., & Elbert, T. (2008). Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial. Journal of consulting and clinical psychology, 76( 4 ) , 6 8 6 . DOI : 10.1037/0022-006X.76.4.686.
  31. Neuner, F., Kurreck, S., Ruf, M., Odenwald, M., Elbert, T., & Schauer, M. (2010). Can asylum-seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study. Cognitive behaviour therapy, 39(2), 81-91. DOI: 10.1080/16506070903121042
  32. Nordbrandt, M. S., Carlsson, J., Lindberg, L. G., Sandahl, H., & Mortensen, E. L. (2015). Treatment of traumatised Refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomized controlled trial. Trials, 16(1), 477.
  33. Palic, S., & Elklit, A. (2009). An explorative outcome study of TCC-based multidisciplinary treatment in a diverse group of Refugees from a Danish treatment centre for rehabilitation of traumatized Refugees. Torture: quarterly journal on rehabilitation of torture victims and prevention of torture, 19(3), 248-270.
  34. Palic, S., & Elklit, A. (2014). Personality dysfunction and complex posttraumatic stress disorder among chronically traumatized Bosnian Refugees. The Journal o f n e r v o u s a n d me n t a l d i s e a s e, 202( 2 ) , 1 1 1 - 1 1 8 . DOI: 10.1097/NMD.0000000000000079.
  35. Paunovic, N., & Ost, L. G. (2001). Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in Refugees. Behaviour research and therapy, 39(10), 1183-1197.
  36. Pocock, N. S., Suphanchaimat, R., Chan, C. K., Faller, E. M., Harrigan, N., Pillai, V., & Wickramage, K. (2018, April). Reflections on migrant and refugee health in Malaysia and the ASEAN region. In BMC proceedings (Vol. 12, No. 4, p. 4). BioMed Central.
  37. Raghavan, S., Rasmussen, A., Rosenfeld, B., & Keller, A. S. (2013). Correlates of symptom reduction in treatment-seeking survivors of torture. Psychological Trauma: Theory, Research, Practice, and Policy, 5(4), 377.
  38. Rees, S., Silove, D. M., Tay, K., & Kareth, M. (2013). Human rights trauma and the mental health of West Papuan Refugees resettled in Australia. Medical Journal of Australia, 199(4), 280-283.
  39. Rees, B., Travis, F., Shapiro, D., & Chant, R. (2014). Significant reductions in posttraumatic stress symptoms in Congolese Refugees within 10 days of Transcendental Meditation practice. Journal of traumatic stress, 27(1), 112-115.
  40. Renner, W., & Berry, J. W. (2011). The ineffectiveness of group interventions for female Turkish migrants with recurrent depression. Social Behavior and Personality: an international journal, 39(9), 1217-1234.
  41. Robjant, K., & Fazel, M. (2010). The emerging evidence for NET: A review. Clinical psychology review, 30(8), 1030-1039.
  42. Schaal, S., Elbert, T., & Neuner, F. (2009). NET versus interpersonal psychothera p y . Psychotherapy and psychosomatics, 78( 5 ) , 2 9 8 - 3 0 6 . DOI: 10.1159/000229768
  43. Schultz, P., Huber, L., & Resick, P. (2006). Practical adaptations of cognitive processing therapy with Bosnian Refugees: Implications for adapting practice to a multiracial clientele. Cognitive and Behavioral Practice, 13(4), 310-321.
  44. Sierre van Wyk, S., Schweitzer, R., Brough, M., Vromans, L., & Murray, K. (2012). A longitudinal study of mental health in Refugees from Burma: The impact of therapeutic interventions. Australian & New Zealand Journal of Psychiatry, 46(10), 995-1003. DOI: 10.1177/0004867412443059
  45. Silove, D., Tay, A. K., Kareth, M., & Rees, S. (2017). The relationship of complex post-traumatic stress disorder and post-traumatic stress disorder in a culturally
  46. distinct, conflict-affected population: A study among West Papuan
  47. Refugees displaced to Papua New Guinea. Frontiers in psychiatry, 8, 73.
  49. Sonne, C., Carlsson, J., Bech, P., Vindbjerg, E., Mortensen, E. L., & Elklit, A. (2016). Psychosocial predictors of treatment outcome for trauma-affected Refugees. European journal of psychotraumatology, 7(1), 30907.
  50. Statistics, U. U. (2019). The world in numbers.
  51. Stenmark, H., Catani, C., Neuner, F., Elbert, T., & Holen, A. (2013). Treating PTSD in Refugees and Asylum seekers within the general health care system. A randomized controlled multicenter study. Behaviour research and therapy, 51(10), 641-647.
  52. Tay, A. K., Miah, M. A. A., Khan, S., Badrudduza, M., Morgan, K., Balasundaram, S., & Silove, D. (2019). Theoretical background, first stage development and adaptation of a novel Integrative Adapt Therapy (IAT) for Refugees. Epidemiology and psychiatric sciences, 1-8. DOI: 10.1017/S2045796019000416
  53. Ter Heide, F. J. J., Mooren, T., Kleijn, W., de Jongh, A., & Kleber, R. (2011). EMDR versus stabilisation in traumatised Asylum seekers and Refugees: Results of a pilot study. European journal of psychotraumatology, 2(1), 5881.
  54. Tran, A. N., Ornelas, I. J., Kim, M., Perez, G., Green, M., Lyn, M. J., & Corbie-
  55. Smith, G. (2014). Results from a pilot promotora program to reduce depression and stress among immigrant Latinas. Health promotion practice, 15(3), 365-372.
  56. Tribe, R. H., Sendt, K. V., & Tracy, D. K. (2017). A systematic review of psychosocial
  57. interventions for adult Refugees and Asylum seekers. Journal of Mental Health, 1-15. doi 10.1080/09638237.2017.1322182 vol pp. DOI: 10.1080/09638237.2017.1322182
  58. UNHCR, I. (2016). Global trends: Forced displacement in 2015. Geneva: UNHCR.
  59. Vijayakumar, L. (2017). Challenges and opportunities in suicide prevention in South-East Asia. WHO South-East Asia journal of public health, 6(1), 30. DOI: 10.4103/2224-3151.206161
  60. Wang, S. J., Bytyci, A., Izeti, S., Kallaba, M., Rushiti, F., Montgomery, E., & Modvig, J. (2016). A novel bio-psycho-social approach for rehabilitation of traumatized victims of torture and war in the post-conflict context: a pilot randomized controlled trial in Kosovo. Conflict and health, 10(1), 34.
  61. Weine, S. M., Kulenovic, A. D., Pavkovic, I., & Gibbons, R. (1999). Testimony psychotherapy in Bosnian Refugees: A pilot study. American Journal of Psychiatry, 155(12), 1720-1726.
  62. Weine, S. M., Raina, D., Zhubi, M., Delesi, M., Huseni, D., Feetham, S., ... & Pavkovic, I. (2003). The TAFES multi-family group intervention for Kosovar
  63. Refugees: A feasibility study. The Journal of nervous and mental disease, 191(2), 100-107. DOI: 10.1097/01.NMD.0000050938.06620.D2
  64. Weine, S. (2008). Family roles in refugee youth resettlement from a prevention perspective. Child and adolescent psychiatric clinics of North America, 17(3), 515-532.
  65. Weinstein, N., Khabbaz, F., & Legate, N. (2016). Enhancing need satisfaction to reduce psychological distress in Syrian Refugees. Journal of Consulting and Clinical Psychology, 84(7), 645.
  66. Whitsett, D., & Sherman, M. F. (2017). Do resettlement variables predict psychiatric treatment outcomes in a sample of asylum-seeking survivors of torture? International journal of social psychiatry, 63(8) , 674-685. DOI: 10.1177/0020764017727022
  67. Zehetmair, C., Kaufmann, C., Tegeler, I., Kindermann, D., Junne, F., Zipfel, S., & Nikendei, C. (2018). Psychotherapeutic Group Intervention for Traumatized Male Refugees using Imaginative Stabilization Techniques–a Pilot Study in a German Reception Center. Frontiers in psychiatry, 9, 533.

  • Migrazioni e psicologie. Introduzione al Forum Alessandro Antonietti, Antonella Marchetti, in RICERCHE DI PSICOLOGIA 1/2020 pp.13
    DOI: 10.3280/RIP2020-001002

Edvaldo Begotaraj, Catia De Paola, Daniela Sambucini, Chiara Ciacchella, Emanuele Caroppo, Carlo Lai, L’efficacia degli interventi psicologici sulla depressione, ansia e somatizzazione nei migranti in "RICERCHE DI PSICOLOGIA " 1/2020, pp 259-274, DOI: 10.3280/RIP2020-001012