Evidence map›Paper›PMID 31948935›Full record

SynthesisThe lancet. Psychiatry2020

Efficacy of psychosocial interventions for mental health outcomes in low-income and middle-income countries: an umbrella review.

Corrado Barbui, Marianna Purgato, Jibril Abdulmalik, Ceren Acarturk, Julian Eaton, Chiara Gastaldon, Oye Gureje, Charlotte Hanlon, Mark Jordans, Crick Lund and 8 more

Open access · greenAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The lancet. Psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 167 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
167citing papers in PubMed, 21 pooled it
44.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

167 citing papers in PubMed, 21 syntheses or guidelines pooled it, 332 citations in OpenAlex.

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107 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 8 countries.

Corrado BarbuiWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. Electronic address: corrado.barbui@univr.it.
Marianna PurgatoWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Jibril AbdulmalikWHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Ceren AcarturkDepartment of Psychology, Koç University, Istanbul, Turkey.
Julian EatonCentre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK.
Chiara GastaldonWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Oye GurejeWHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Charlotte HanlonCentre for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; WHO Collaborating Centre for Mental Health Research and Capacity Building, Department of Psychiatry, School of Medicine and Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Mark JordansCentre for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands.
Crick LundCentre for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Michela NosèWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Giovanni OstuzziWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Davide PapolaWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Federico TedeschiWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Wietse TolDepartment of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Giulia TurriniWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
Vikram PatelDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Graham ThornicroftCentre for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Centre for Implementation Science, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
University of Verona · ITKing's College London · GBUniversity of Ibadan · NGHarvard University · USJohns Hopkins University · USKoç University · TRLondon School of Hygiene & Tropical Medicine · GBUniversity of Amsterdam · NL

Funding

Medical Research Council MR/R023697/1Medical Research Council MR/S001255/1
6 · The paper itself

Abstract

backgroundMental health conditions are leading causes of disability worldwide. Psychosocial interventions for these conditions might have a key role in their treatment, although applicability of findings to poor-resource settings might be a challenge. We aimed to evaluate the strength and credibility of evidence generated in low-income and middle-income countries (LMICs) on the efficacy of psychosocial interventions for various mental health outcomes.

methodsWe did an umbrella review of meta-analyses of randomised studies done in LMICs. Literature searches were done in Medline, Embase, PsychINFO, CINAHL, Cochrane Library, and Epistemonikos from Jan 1, 2010, until May 31, 2019. Systematic reviews of randomised studies investigating the efficacy of psychosocial interventions for mental health conditions in LMICs were included. Systematic reviews of promotion, prevention, and protection interventions were excluded, because the focus was on treatment interventions only. Information on first author, year of publication, outcomes, number of included studies, and reported summary meta-analytic estimates was extracted from included meta-analyses. Summary effects were recalculated using a common metric and random-effects models. We assessed between-study heterogeneity, predictive intervals, publication bias, small-study effects, and whether the results of the observed positive studies were more than expected by chance. On the basis of these calculations, strength of associations was assessed using quantitative umbrella review criteria, and credibility of evidence using the GRADE approach. This study is registered with PROSPERO, number CRD42019135711.

findings123 primary studies from ten systematic reviews were included. The evidence on the efficacy of psychosocial interventions in adults with depression in humanitarian settings (standardised mean difference 0·87, 95% CI 0·67-1·07; highly suggestive association, GRADE: moderate) and in adults with common mental disorders (0·49, 0·36-0·62; highly suggestive association, GRADE: moderate) was supported by the most robust evidence. Highly suggestive strength of association was found for psychosocial interventions in adults with schizophrenia for functional outcomes, in adults with depression, and in adults with post-traumatic stress disorder in humanitarian settings. In children in humanitarian settings, and in children with disruptive behaviour, psychosocial interventions were supported by suggestive evidence of efficacy.

interpretationA relatively large amount of evidence suggests the benefit of psychosocial interventions on various mental health outcomes in LMICs. However, strength of associations and credibility of evidence were quite variable, depending on the target mental health condition, type of population and setting, and outcome of interest. This varied evidence should be considered in the development of clinical, policy, and implementation programmes in LMICs and should prompt further studies to improve the strength and credibility of the evidence base.

fundingUniversity of Verona.

Indexed as

Meta-Analysis as TopicDeveloping CountriesHumansMental DisordersOutcome Assessment, Health CarePsychotherapyRandomized Controlled Trials as Topic

Identifiers

PMID31948935
OpenAlexW3000683427

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.