BACKGROUND: Existing studies of mental health interventions in low-resource settings have employed highly structured interventions delivered by non-professionals that typically do not vary by client. Given high comorbidity among mental health problems and implementation challenges with scaling up multiple structured evidence-based treatments (EBTs), a transdiagnostic treatment could provide an additional option for approaching community-based treatment of mental health problems. Our objective was to test such an approach specifically designed for flexible treatments of varying and @entity74 among @entity130 survivors in a low-resource setting. METHODS AND FINDINGS: We conducted a single-blinded, wait-list randomized controlled trial of a newly developed transdiagnostic psychotherapy, Common Elements Treatment Approach (CETA), for low-resource settings, compared with @entity23 ( @entity23 ). CETA was delivered by lay workers to Burmese survivors of imprisonment, torture, and related @entity130 , with flexibility based on client presentation. Eligible @entity1 reported @entity130 exposure and met severity criteria for @entity308 and/or posttraumatic stress (PTS). @entity1 were randomly assigned to CETA (n = 182) or @entity23 (n = 165). Outcomes were assessed by interviewers blinded to @entity1 allocation using locally adapted standard measures of @entity308 and PTS (primary outcomes) and functional impairment, @entity148 , @entity146 , and @entity167 use (secondary outcomes). Primary analysis was intent-to-treat (n = 347), including 73 @entity1 lost to follow-up. CETA @entity1 experienced significantly greater reductions of baseline symptoms across all outcomes with the exception of @entity167 use ( @entity167 use analysis was confined to problem drinkers). The difference in mean change from pre-intervention to post-intervention between intervention and control groups was -0.49 (95% CI: -0.59, -0.40) for @entity308 , -0.43 (95% CI: -0.51, -0.35) for PTS, -0.42 (95% CI: -0.58, -0.27) for functional impairment, -0.48 (95% CI: -0.61, -0.34) for @entity148 , -0.24 (95% CI: -0.34, -0.15) for @entity146 , and -0.03 (95% CI: -0.44, 0.50) for @entity167 use. This corresponds to a 77% reduction in mean baseline @entity308 score among CETA @entity1 compared to a 40% reduction among controls, with respective values for the other outcomes of 76% and 41% for @entity148 , 75% and 37% for PTS, 67% and 22% for functional impairment, and 71% and 32% for @entity146 . Effect sizes (Cohen's d) were large for @entity308 (d=1.16) and PTS (d=1.19); moderate for impaired function (d = 0.63), @entity148 (d = 0.79), and @entity146 (d = 0.58); and none for @entity167 use. There were no adverse events. Limitations of the study include the lack of long-term follow-up, non-blinding of service providers and @entity1 , and no placebo or active comparison intervention. CONCLUSIONS: CETA provided by lay counselors was highly effective across disorders among @entity130 survivors compared to WLCs. These results support the further development and testing of transdiagnostic approaches as possible treatment options alongside existing EBTs. TRIAL REGISTRATION: ClinicalTrials.gov NCT01459068 Please see later in the article for the Editors' Summary.

A transdiagnostic community-based mental health treatment for XXXX : development and outcomes of a randomized controlled trial among burmese refugees in Thailand.

@entity1 :: ('9606', 'Species') :: ['participants', 'participant', 'Participants'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggression'] @entity167 :: ('CHEBI:16236', 'Chemical') :: ['alcohol'] @entity23 :: ('MESH:D007174', 'Disease') :: ['WLC', 'wait-list control'] @entity148 :: ('MESH:D001008', 'Disease') :: ['anxiety symptoms', 'anxiety'] @entity74 :: ('MESH:D030342', 'Disease') :: ['comorbid disorders'] @entity130 :: ('MESH:D014947', 'Disease') :: ['traumas', 'trauma']
@entity74 :: (MESH:D030342,Disease) :: ['comorbid disorders']
