Culturally adapted Metacognitive Training for Depression (CA-D-MCT) for Arabic- and Farsi-speaking refugees: a feasibility trial.

Background

A significant number of people with a refugee background suffer from depression and may benefit from psychological interventions. Culturally adapted Metacognitive Training for Depression (CA-D-MCT) is a low-threshold and resource-saving group intervention that has not yet been evaluated among refugees with depression.

Objective

This study aimed to assess the feasibility, patient acceptance, and initial treatment effects on depression and other secondary outcomes of CA-D-MCT for refugees with depression, potentially presenting with comorbid post-traumatic stress disorder (PTSD).Method: In an uncontrolled feasibility trial, 50 adult refugees with a diagnosis of depression, who spoke Arabic or Farsi, received interpreter-assisted CA-D-MCT. Patients completed module evaluations to assess acceptability. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9) at baseline (t0), post-treatment (t1) and at three-month follow-up (t2). Secondary outcomes included quality of life, subjective integration and PTSD symptoms.

Results

Descriptive analysis showed a high level of acceptability of the intervention. A repeated-measure ANOVA revealed a large effect size associated with improvements in depressive symptoms (η² = .175, p = .010), suggesting a positive treatment effect. Medium effect sizes were observed for subjective integration, quality of life and PTSD symptoms, but differential values were not statistically significant.

Conclusions

CA-D-MCT seems to be feasible and well accepted. The findings provide preliminary evidence for a treatment effect of CA-D-MCT. A randomized controlled trial is warranted to further investigate its efficacy.