Imagery Rehearsal Therapy and mianserin for trauma-affected refugees
Follow-up of a randomized controlled trial
DOI:
https://doi.org/10.7146/torture.v34i2.141339Keywords:
PTSD, refugee, behavioral treatment, sleep, IRTAbstract
Introduction:
In order to identify the efficacy of treatment interventions for trauma-affected refugees follow-up studies are highly warranted. Hence, the overall aim of this study was to examine the efficacy of sleep-enhancing treatment, IRT and mianserin, in a sample of 219 trauma-affected refugees at six-month follow-up post-treatment.
Methods
Data were derived from a four-armed randomized controlled trial in a sample of trauma-affected refugees with PTSD. All four arms received Treatment as Usual (TAU), an interdisciplinary treatment approach: one group received solely TAU, serving as a control group, whereas the remaining three groups were active-treatment groups receiving add-on treatment with either IRT, mianserin, or a combination.
Mixed models were used to analyze the combinations of the two treatment factors (IRT vs. non-IRT and mianserin vs non-mianserin) and time (baseline vs follow-up and post-treatment vs follow-up) for the primary outcome sleep quality and for several secondary outcome measures.
Results
A total of 36.7% of the participants had been exposed to torture and 44% had been imprisoned.
The only significant effect of IRT was on well-being (measured with WHO-5), where IRT showed higher improvement in well-being six months post-treatment (p = .027). There was no significant effect of mianserin on any of the outcome measures.
Discussion
This follow-up study found improvements from baseline to post-treatment on sleep quality and most of the secondary outcome measures that were maintained for all treatment conditions at the six-month follow-up assessment. A limitation of the study was that a high proportion (53.4%) of the participants did not attend the follow-up evaluation.
The results indicate that add-on IRT-treatment and add-on mianserin-treatment were not superior to TAU at six-month follow-up post-treatment.
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