Effectiveness of a group psychological intervention to reduce psychosocial distress in adolescents in Pakistan: a single-blind, cluster randomised controlled trial.

Hamdani, Syed Usman, Huma, Zill-E, Malik, Aiysha, Tamizuddin-Nizami, Asad, Javed, Hashim, Minhas, Fareed Aslam, Jordans, Mark J D, Sijbrandij, Marit, Suleman, Nadia, Baneen, Um-Ul, Bryant, Richard Allan, van Ommeren, Mark, Rahman, Atif and Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464 (2024) 'Effectiveness of a group psychological intervention to reduce psychosocial distress in adolescents in Pakistan: a single-blind, cluster randomised controlled trial.'. The Lancet Child & Adolescent Health, Vol 8, Issue 8, pp. 559-570.

Preview

Text Effectiveness of a group psychological intervention to reduce psychosocial distress in adolescents in Pakistan.pdf - Published Version Available under License Creative Commons Attribution. Download (4MB) | Preview

Abstract

Background
Emotional problems in adolescents living in low-income and middle-income countries (LMICs) remain largely unaddressed; key reasons include a scarcity of trained mental health professionals and unavailability of evidence-based, scalable psychological interventions. We aimed to evaluate the effectiveness of a non-specialist-delivered, group psychological intervention to reduce psychosocial distress in school-going adolescents in Pakistan.

Methods
In a two-arm, single-blind, cluster randomised controlled trial, eligible public school clusters from a rural subdistrict of Gujar Khan, Rawalpindi, Pakistan, were randomised (1:1, stratified by sex) using permuted block randomisation into intervention (n=20) and wait-list control (n=20) groups. Adolescents aged 13–15 years who provided informed assent and caregivers’ consent were screened for psychosocial distress using the youth-reported Pediatric Symptoms Checklist (PSC; total psychosocial distress scores from 0 to 70), and those scoring 28 or more and their caregivers were enrolled into the trial. Adolescents in the intervention group received seven weekly group sessions and their caregivers received three biweekly group sessions in school settings from trained non-specialists. The primary outcome was change from baseline in the total PSC scores at 3 months post-intervention. The trial was registered prospectively with the International Standard Randomised Controlled Trial Number registry, ISRCTN17755448.

Findings
From the 40 school clusters that were included, 282 adolescents in the intervention group and 284 adolescents in the wait-list control group were enrolled between Nov 2 and Nov 30, 2021. At 3 months, adolescents in the intervention group had significantly lower mean total score on the PSC compared with adolescents in the control group (mean difference in change from baseline 3·48 [95% CI 1·66–5·29], p=0·0002, effect size 0·38 [95% CI 0·18–0·57]; adjusted mean difference 3·26 (95% CI 1·46–5·06], p=0·0004, effect size 0·35 (0·16–0·55). No adverse events were reported in either group.

Interpretation
The group psychological intervention most likely represents a feasible and effective option for adolescents with psychosocial distress in school settings.

Item Type:	Article
Subjects:	WM Psychiatry > WM 20 Research (General) WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/S2352-4642(24)00101-9
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	13 Aug 2024 14:59
Last Modified:	13 Aug 2024 15:02
URI:	https://archive.lstmed.ac.uk/id/eprint/25036

Statistics

View details

Actions (login required)

Edit Item