Background: People forced to leave their homes, such as refugees and internally displaced persons, are exposed to various stressors during their forced displacement, putting them at risk for mental disorders.Objective: To summarize evidence on the efficacy of psychosocial interventions aiming to promote mental health and/or to prevent mental symptoms by fostering transdiagnostic skills in forcibly displaced persons of all ages.Method: Four databases and reference lists were searched for randomized controlled trials on interventions in this population on 11 March 2022. Thirty-six studies were eligible, 32 studies (comprising 5299 participants) were included in random-effects multilevel meta-analyses examining the effects of interventions on mental symptoms and positive mental health (e.g. wellbeing) as well as moderators to account for heterogeneity. OSF Preregistration-ID: 10.17605/OSF.IO/XPMU3Results: Our search resulted in 32 eligible studies, with 10 reporting on children/adolescents and 27 on adult populations. There was no evidence for favourable intervention effects in children/adolescents, with 44.4% of the effect sizes pointing to potentially negative effects yet remaining non-significant. For adult populations, our meta-analyses showed a close-to-significant favourable effect for mental symptoms, M(SMD) = 0.33, 95% CI [-0.03, 0.69], which was significant when analyses were limited to high-quality studies and larger for clinical compared to non-clinical populations. No effects emerged for positive mental health. Heterogeneity was considerable and could not be explained by various moderators (e.g. type of control, duration, setting, theoretical basis). Certainty of evidence was very low across all outcomes limiting the generalizability of our findings.Conclusion: The present review provides at most weak evidence for an effect favouring transdiagnostic psychosocial interventions over control conditions for adult populations but not for children and adolescents. Future research should combine the imperative of humanitarian aid in face of major crises with studying the diverse needs of forcibly displaced persons to improve and tailor future interventions.
Antecedentes: Las personas obligadas a abandonar sus hogares, como los refugiados y personas desplazadas internamente, están expuestas a diversos factores estresantes durante sus desplazamientos forzados, lo que los pone en riesgo de sufrir trastornos mentales.
背景：被迫离开家园的人，如难民和国内流离失所者，在被迫流离失所期间会面临各种应激源，使他们面临精神障碍的风险。
目的：总结旨在通过发展跨诊断技能来促进所有年龄段被迫流离失所者心理健康和/或预防精神症状的社会心理干预效果的证据。
方法： 在 2022 年 3 月 11 日搜索了四个数据库和参考列表，以查找在此群体中干预措施的随机对照试验。36 项研究符合条件，32 项研究（包括 5,299 名参与者）被纳入随机效应多水平元分析，以考查对精神症状和积极心理健康（例如幸福感）的干预以及解释异质性的调节因素。 OSF 预注册号：10.17605/OSF.IO/XPMU3
结果：我们的检索产生了 32 项符合条件的研究，其中 10 项针对儿童/青少年，27 项针对成年人。 没有证据表明干预效果在儿童/青少年更有利，44.4% 的效应量指向有潜在负面作用但仍然不显著。 对于成年人群，我们的元分析显示对精神症状有接近显著的有利影响，M(SMD) = 0.33, 95% CI [–0.03, 0.69]，当分析仅限于高质量时显著且在临床群体比非临床人群效应更大。 对积极心理健康没有影响。 异质性相当大，无法被各种调节因素（例如，控制类型、持续时间、设置、理论基础）解释。 所有结果的证据质量都非常低，限制了我们研究结果的可推广性。
结论：本综述至多为支持跨诊断心理社会干预对成年人的效果优于控制条件的影响但对儿童和青少年则不然提供了微弱的证据。 未来的研究应该将面对重大危机时人道主义援助的必要性与研究被迫流离失所者的不同需求结合起来，以改进和精确调整未来的干预措施。
Keywords: Refugees; Refugiados; desplazamiento; displacement; intervención psicosocial; meta-analysis; metanálisis; psychosocial intervention; revisión sistemática; systematic review; trans diagnóstico; transdiagnostic; 元分析; 流离失所; 社会心理干预; 系统综述; 跨诊断; 难民.
This review is the first to examine the efficacy of transdiagnostic interventions for mental health promotion and prevention of mental disorders in forcibly displaced persons of all ages.Overall, we found no favourable effect of transdiagnostic interventions in both children/adolescents and adults. Excluding studies at high risk of bias, there was weak evidence for a small favourable effect in adults, but not in children and adolescents. Thus, so far, there is weak evidence for transdiagnostic interventions in forcibly displaced persons.Research efforts need to match care needs: While most people live and need care in low-income countries, the majority of research has been conducted in high-income countries.