***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Traumatic stress due to conflict and war causes major mental health problems in many re source -poor countries . The objective of this study was to examine whether trained lay counselors can carry out effective treatment of  posttraumatic stress disorder ( PTSD )  in a refugee settlement . In a r and omized controlled dissemination trial in Ug and a with 277 Rw and an and Somalian refugees who were diagnosed with PTSD the authors investigated the effectiveness of psychotherapy administered by lay counselors . Strictly manualized narrative exposure therapy ( NET ) was compared with more flexible trauma counseling ( TC ) and a no-treatment monitoring group ( MG ) . Fewer participants ( 4 % ) dropped out of NET treatment than TC ( 21 % ) . Both active treatment groups were statistically and clinical ly superior to MG on PTSD symptoms and physical health but did not differ from each other . At follow-up , a PTSD diagnosis could not be established anymore in 70 % of NET and 65 % TC participants , whereas only 37 % in MG did not meet PTSD criteria anymore . Short-term psychotherapy carried out by lay counselors with limited training can be effective to treat war-related PTSD in a refugee settlement OBJECTIVE Becoming a refugee is a potent risk factor for indicators of psychological distress such as depression , generalized stress , and posttraumatic stress disorder ( PTSD ) , though research into this vulnerable population has been scant , with even less work focusing on interventions . The current study applied principles from self-determination theory ( SDT ; Ryan & Deci , 2000 ) to develop and test an intervention aim ed at increasing need-satisfying experiences in refugees of Syrian civil unrest . METHOD Forty-one refugees who fled Syria during the past 24 months and resettled in Jordan participated in the study and were r and omly assigned to receive the intervention or a neutral comparison . RESULTS The 1-week-long intervention alleviated some of the need frustration likely associated with refugee status , a major aim of the intervention , and also lowered refugees '  self-reported symptoms of depression and generalized stress as compared to the comparison condition , though it did not reduce symptoms of PTSD . CONCLUSIONS Discussion focuses on how these findings speak to the universal importance of need satisfaction for mental health , and how need-satisfying experiences can help buffer against the profound stress of being a refugee . Avenues for longer-term or more intensive interventions that may target more severe outcomes of refugee experiences , such as PTSD symptoms , are also discussed . ( PsycINFO Data base OBJECTIVE There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in st and ard psychiatric setting s in industrialized countries . In this study , Narrative Exposure Therapy ( NET ) was compared to Treatment As Usual ( TAU ) in 11 general psychiatric health care units in Norway . The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression . METHOD Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD ( N = 81 ) were r and omized with an a-priori probability of 2:1 to either NET ( N = 51 ) or TAU ( N = 30 ) . The patients were assessed with Clinician Administered PTSD Scale , Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment , and again at one and six months after the completion . RESULTS Both NET and TAU gave clinical ly relevant symptom reduction both in PTSD and in depression . NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses . No difference in treatment efficacy was found between refugees and asylum seekers . CONCLUSIONS The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system ; NET appeared to be a promising treatment for both groups We examined the feasibility , acceptability , and therapeutic efficacy of a culturally adapted cognitive – behavior therapy ( CBT ) for twelve Vietnamese refugees with treatment-resistant posttraumatic stress disorder ( PTSD ) and panic attacks . These patients were treated in two separate cohorts of six with staggered onset of treatment . Repeated measures Group × Time ANOVAs and between-group comparisons indicated significant improvements , with large effect sizes ( Cohen 's d ) for all outcome measures : Harvard Trauma Question naire ( HTQ ; d=2.5 ) ; Anxiety Sensitivity Index ( ASI ; d=4.3 ) ; Hopkins Symptom Checklist-25 ( HSCL-25 ) , anxiety subscale ( d=2.2 ) ; and Hopkins Symptom Checklist-25 , depression subscale ( d=2.0 ) scores . Likewise , the severity of ( culturally related ) headache- and orthostasis-cued panic attacks improved significantly across Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions .  Narrative exposure therapy ( NET ) is a short-term approach based on cognitive-behavioral therapy and testimony therapy . The efficacy of narrative exposure therapy was evaluated in a r and omized controlled trial . Sudanese refugees living in a Ug and an refugee settlement ( N = 43 ) who were diagnosed as suffering from posttraumatic stress disorder ( PTSD ) either received 4 sessions of NET , 4 sessions of supportive counseling ( SC ) , or psychoeducation ( PE ) completed in 1 session . One year after treatment , only 29 % of the NET participants but 79 % of the SC group and 80 % of the PE group still fulfilled PTSD criteria . These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions BACKGROUND Previous research indicates a high prevalence of post-traumatic stress disorder ( PTSD ) and depression among refugees .  Eye movement desensitization and reprocessing ( EMDR ) is an effective treatment for PTSD for victims of natural disasters , car accidents or other traumatic events . The current study examined the effect of EMDR on symptoms of PTSD and depression by comparing the treatment with a wait-list control condition in Syrian refugees . METHOD Adult refugees located in Kilis Refugee Camp at the Turkish-Syrian border with a PTSD diagnosis were r and omly allocated to either EMDR  ( n = 37 ) or wait-list control  ( n = 33 ) conditions . All participants were assessed with the Mini-International Neuropsychiatric Interview Plus at pre-intervention , at 1 week after finishing the intervention and at 5 weeks after finishing the intervention . The main outcome measures were the Harvard Trauma Question naire ( HTQ ) and the Impact of Event Scale-Revised . The Beck Depression Inventory and the Hopkins Symptoms Checklist-25 were included as secondary outcome measures . The Trial Registration no. is NCT01847742 . RESULTS Mixed-model analyses adjusted for the baseline scores indicated a significant effect of group at post-treatment indicating that the EMDR therapy group showed a significantly larger reduction of PTSD symptoms as assessed with the HTQ . Similar findings were found on the other outcome measures . There was no effect of time or group × time interaction on any measure , showing that the difference between the groups at the post-treatment was maintained to the 5-week follow-up . CONCLUSIONS EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees with PTSD located in a refugee camp Background Traumatised asylum seekers and refugees are clinical ly considered a complex population . Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder ( PTSD ) should be followed and Trauma-Focused Cognitive-Behavioural Therapy ( TF-CBT ) or Eye Movement Desensitisation and Reprocessing ( EMDR ) should be applied , or whether a phased model starting with stabilisation is preferable . Some clinicians fear that trauma-focused interventions may lead to unmanageable distress or may be ineffective . While cognitive-behavioural interventions have been found to be effective with traumatised refugees , no studies concerning the efficacy of EMDR with this population have been conducted as yet . Objective In preparation for a r and omised trial comparing EMDR and stabilisation with traumatised refugees , a pilot study with 20 participants was conducted . The objective was to examine feasibility of participation in a r and omised trial for this complex population and to examine acceptability and preliminary efficacy of EMDR . Design Participants were r and omly allocated to 11 sessions of either EMDR or stabilisation .  Symptoms of PTSD ( SCID-I , HTQ ) , depression and anxiety ( HSCL-25 ) , and quality of life ( WHOQOL-BREF ) were assessed at pre- and post-treatment and 3-month follow-up . Results Participation of traumatised refugees in the study was found feasible , although issues associated with complex traumatisation led to a high pre-treatment attrition and challenges in assessment s. Acceptability of EMDR was found equal to that of stabilisation with a high drop-out for both conditions . No participants dropped out of the EMDR condition because of unmanageable distress . While improvement for EMDR participants was small , EMDR was found to be no less efficacious than stabilisation . Different symptom courses between the two conditions , with EMDR showing some improvement and stabilisation showing some deterioration between pre-treatment and post-treatment , justify the conduct of a full trial . Conclusion With some adaptations in study design , inclusion of a greater sample is justifiable to determine which treatment is more suitable for this complex population . For the abstract or full text in other language s , please see Supplementary files under Reading Tools BACKGROUND Little evidence exists on the treatment of traumatised refugees . AIMS To estimate treatment effects of flexible cognitive-behavioural therapy ( CBT ) and antidepressants ( sertraline and mianserin ) in traumatised refugees . METHOD R and omised controlled clinical trial with 2 × 2 factorial design ( registered with Clinical trials.gov , NCT00917397 , EUDRACT no. 2008 - 006714 - 15 ) . Participants were refugees with war-related traumatic experiences , post-traumatic stress disorder ( PTSD ) and without psychotic disorder . Treatment was weekly sessions with a physician and /or psychologist over 6 months . RESULTS A total of 217 of 280 patients completed treatment ( 78 % ) . There was no effect on PTSD symptoms , no effect of psychotherapy and no interaction between psychotherapy and medicine . A small but significant effect of treatment with antidepressants was found on depression . CONCLUSIONS In a pragmatic clinical setting , there was no effect of flexible CBT and antidepressants on PTSD , and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees Background The most common mental health problems among refugees are depression and posttraumatic stress disorder ( PTSD ) . Eye movement desensitization and reprocessing ( EMDR ) is an effective treatment for PTSD . However , no previous r and omized controlled trial ( RCT ) has been published on treating PTSD symptoms in a refugee camp population . Objective Examining the effect of EMDR to reduce the PTSD and depression symptoms compared to a wait-list condition among Syrian refugees . Method Twenty-nine adult participants with PTSD symptoms were r and omly allocated to either EMDR sessions ( n=15 ) or wait-list control ( n=14 ) . The main outcome measures were Impact of Event Scale-Revised ( IES-R ) and Beck Depression Inventory ( BDI-II ) at posttreatment and 4-week follow-up . Results Analysis of covariance showed that the EMDR group had significantly lower trauma scores at posttreatment as compared with the wait-list group ( d=1.78 , 95 % CI : 0.92–2.64 ) . The EMDR group also had a lower depression score after treatment as compared with the wait-list group ( d=1.14 , 95 % CI : 0.35–1.92 ) . Conclusion The pilot RCT indicated that EMDR may be effective in reducing  PTSD and depression symptoms among Syrian refugees located in a camp . Larger RCTs to verify the ( cost- ) effectiveness of EMDR in similar population s are needed Background Little is known about the neurobiological foundations of psychotherapy for Posttraumatic Stress Disorder ( PTSD ) . Prior studies have shown that PTSD is associated with altered processing of threatening and aversive stimuli . It remains unclear whether this functional abnormality can be changed by psychotherapy . This is the first r and omized controlled treatment trial that examines whether narrative exposure therapy ( NET ) causes changes in affective stimulus processing in patients with chronic PTSD . Methods 34 refugees with PTSD were r and omly assigned to a NET group or to a waitlist control ( WLC ) group . At pre-test and at four-months follow-up , the diagnostics included the assessment of clinical variables and measurements of neuromagnetic oscillatory brain activity ( steady-state visual evoked fields , ssVEF ) result ing from exposure to aversive pictures compared to neutral pictures . Results PTSD as well as depressive symptom severity scores declined in the NET group , whereas symptoms persisted in the WLC group . Only in the NET group , parietal and occipital activity towards threatening pictures increased significantly after therapy . Conclusions Our results indicate that NET causes an increase of activity associated with cortical top-down regulation of attention towards aversive pictures . The increase of attention allocation to potential threat cues might allow treated patients to re-appraise the actual danger 
    Output:
    
RESULTS This review found medium to high quality evidence supporting the use of narrative exposure therapy ( NET ) .
A lack of culturally adapted treatments was apparent and there was less evidence to support st and ard  cognitive behavioural therapy ( CBT ) , Eye Movement Desensitisation and Reprocessing ( EMDR )  and  multidisciplinary treatments .
CONCLUSION NET produced positive outcomes in refugees from a diverse range of background s and trauma types .