***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 Background An earlier study showed that a week of yoga practice was useful in stress management after a natural calamity . Due to heavy rain and a rift on the banks of the Kosi river , in the state of Bihar in north India , there were floods with loss of life and property . A week of yoga practice was given to the survivors a month after the event and the effect was assessed . Methods Twenty-two volunteers ( group average age ± S.D , 31.5 ± 7.5 years ; all of them were males ) were r and omly assigned to two groups , yoga and a non-yoga wait-list control group . The yoga group practice d yoga for an hour daily while the control group continued with their routine activities . Both groups ' heart rate variability , breath rate , and four symptoms of emotional distress using visual analog scales , were assessed on the first and eighth day of the program . Results There was a significant decrease in sadness in the yoga group ( p < 0.05 , paired t-test , post data compared to pre ) and an increase in anxiety in the control group ( p < 0.05 , paired t-test , post data compared to pre ) . Conclusions A week of yoga can reduce feelings of sadness and possibly prevent an increase in anxiety in flood survivors a month after the calamity . Trial Registration Clinical Trials Registry of India : Background Narrative exposure therapy ( NET ) is a brief , manualised treatment for Posttraumatic Stress Disorder ( PTSD ) . It has been shown to have therapeutic benefits for a wide range of individuals and setting s. This study , following our previous work applying the original NET in earthquake survivors , aim ed to revise NET to be adaptable for treating PTSD after a natural disaster . Methods A r and omised waiting-list controlled study was conducted with 30 adult participants with PTSD who were r and omly allocated to NET ( n?=?10 ) , revised NET ( NET-R ; n?=?10 ) or a waiting list condition  ( WL ; n?=?10 ) . Participants in NET and NET-R received treatment immediately ; those in the WL condition received NET-R treatment after a waiting period . All groups were assessed on PTSD , general distress , anxiety , depression , social support , coping and posttraumatic change before and after treatment and three-month follow-up . Results Compared with WL , both NET and NET-R groups showed significant reductions in PTSD and related symptoms . Significant increases were found in posttraumatic growth , active coping and perceived social support . The WL group showed similar improvements after treatment . Further reductions on PTSD symptoms were found at three months , showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors . Conclusions NET-R is a feasible and cost-effective intervention for Chinese earthquake survivors . Further studies are needed to replicate these findings in other survivor population s , and with larger sample s and over longer periods . This study highlighted the value of oral narrative approach , which is well-accepted and useful in the context of single natural disaster and lower- income area . Trial registration Chinese Clinical Trial Registry : Background Post-Traumatic Stress Disorder ( PTSD ) is a common psychological reaction after large-scale natural disasters . Given the number of people involved and shortage of re sources in any major disaster , brief , pragmatic and easily trainable interventions are needed . The aim of this study is to evaluate the efficacy of Narrative Exposure Therapy ( NET ) as a short-term treatment for PTSD using Chinese earthquake survivors . Methods A r and omized waiting-list control pilot study was conducted between December 2009 and March 2010 , at the site of the Sichuan earthquake in Beichuan County , China . Adult participants with newly diagnosed Post Traumatic Stress Disorder ( PTSD ) were r and omly allocated to Narrative Exposure Therapy ( NET ) or a Waiting-List ( WL ) condition . The latter received NET treatment after a two-week waiting period . To compare the effectiveness of NET in traumatised earthquake survivors , both groups were assessed on PTSD symptoms , general mental health , anxiety and depression , social support , coping style and posttraumatic change before and after treatment and two months post treatment . Results Adult participants ( n=22 ) were r and omly allocated to receive NET ( n=11 ) or WL ( n=11 ) . Twenty two participants ( 11 in NET group , 11 in WL ) were included in the analysis of primary outcomes . Compared with WL , NET showed significant reductions in PTSD symptoms , anxiety and depression , general mental stress and increased posttraumatic growth . The WL group later showed similar improvements after treatment . These changes remained stable for a two-month follow-up . Measures of social support and coping showed no stable effects . Conclusions NET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors . The findings help advance current knowledge in the management of PTSD after natural disasters and inform future research . Larger sample sizes are needed to extend the present findings .Trial registration Chinese Clinical Trial Registry In a r and omized controlled trial , Paul Bolton and colleagues investigate whether a transdiagnostic community-based intervention is effective for improving mental health symptoms among Burmese refugees in Thail and . Please see later in the article for the Editors ' Providing survivors of torture , imprisonment , and /or military attacks with a counseling program that includes support , skills and psychoeducation by well-trained and supervised community mental health workers can result in moderate yet meaningful improvements in depression and dysfunction . Providing survivors of torture , imprisonment , and /or military attacks with a counseling program that includes support , skills and psychoeducation by well-trained and supervised community mental health workers can result in moderate yet meaningful improvements in depression and dysfunction . ABSTRACT Supportive counseling type interventions are frequently provided to meet the mental health needs of population s in emergency and post-conflicts context s , but it has seldom been rigorously evaluated . Existing evaluations from low- and middle-income countries provide mixed evidence of effectiveness . While Iraqi Kurdistan experienced relative stability following the fall of Saddam Hussein ’s government , the population in the northern Dohuk region has continued to experience periodic violence due to conflicts with neighboring Turkey as well as more recent ISIS-associated violence . We evaluated the impact of a trauma-informed support , skills , and psychoeducation intervention provided by community mental health workers ( CMHWs ) on depressive symptoms and dysfunction ( primary outcomes ) as well as post-traumatic stress , traumatic grief , and anxiety symptoms ( secondary outcomes ) . Between June 2009 and June 2010 , 295 adults were screened ; 209 ( 71 % ) met eligibility criteria ( trauma exposure and a symptom severity score indicating significant distress and functional impairment , among others ) and consented to participate . Of these , 159 were r and omized to supportive counseling while 50 were r and omized to a waitlist control condition . Comparing average symptom severity scores post-treatment among those in the intervention group with those in the waitlist control group , the supportive counseling program had statistically and clinical ly significant impacts on the primary outcomes of depression ( Cohen ’s d , 0.57 ; P = .02 ) and dysfunction ( Cohen ’s d , 0.53 ; P = .03 ) and significant but smaller impacts on anxiety . Although studies by the same research team of psychotherapeutic interventions in other parts of Kurdistan and in southern Iraq found larger effects , this study adds to the global research literature on mental health and psychosocial support and shows that a well-trained and supervised program of trauma-informed support , skills , and psychoeducation that emphasizes the therapeutic relationship can also be effective Testimony therapy can provide low-cost , brief , simple , and culturally adaptable psychosocial services in low-income countries ( Agger , Raghuvanshi , Khan , Polatin , & Laursen , 2009 ) . Nonetheless , there have been no well-controlled studies of testimony therapy . We report the analyses of a r and omized controlled trial design ed to assess the effectiveness of testimony therapy plus a culturally adapted ceremony in reducing mental health symptoms among Khmer Rouge torture survivors from across Cambodia . Using multilevel modeling , we compared symptoms of posttraumatic stress disorder , anxiety , and depression between a treatment ( n = 45 ) and a control group ( n = 43 ) at baseline , 3 months , and 6 months . We found that testimony therapy plus ceremony significantly reduced symptoms of posttraumatic stress disorder ( d = 0.49 ) , anxiety ( d = 0.44 ) , and depression ( d = 0.53 ) Importance The mental health consequences of conflict and violence are wide-ranging and pervasive . Scalable interventions to address a range of mental health problems are needed . Objective To test the effectiveness of a multicomponent behavioral intervention delivered by lay health workers to adults with psychological distress in primary care setting s. Design , Setting , and Participants A r and omized clinical trial was conducted from November 1 , 2014 , through January 28 , 2016 , in 3 primary care centers in Peshawar , Pakistan , that included 346 adult primary care attendees with high levels of both psychological distress and functional impairment according to the 12-item General Health Question naire and the World Health Organization Disability Assessment Schedule 2.0 ( WHODAS 2.0 ) . Interventions Lay health workers administered 5 weekly 90-minute individual sessions that included empirically supported strategies of problem solving , behavioral activation , strengthening social support , and stress management . The control was enhanced usual care . Main Outcomes and Measures Primary outcomes , anxiety and depression symptoms , were independently measured at 3 months with the Hospital Anxiety and Depression Scale ( HADS ) . Secondary outcomes were posttraumatic stress symptoms ( Posttraumatic Stress Disorder Checklist for DSM-5 ) , functional impairment ( WHODAS 2.0 ) , progress on problems for which the person sought help ( Psychological Outcome Profiles ) , and symptoms of depressive disorder ( 9-item Patient Health Question naire ) . Results Among 346 patients ( mean [ SD ] age , 33.0 [ 11.8 ] years ; 78.9 % women ) , 172 were r and omly assigned to the intervention and 174 to enhanced usual care ;  among them , 146 and 160 completed the study , respectively . At baseline , the intervention and control groups had similar mean ( SD ) HADS scores on symptoms of anxiety ( 14.16 [ 3.17 ] vs 13.64 [ 3.20 ] ; adjusted mean difference [ AMD ] , 0.52 ; 95 % CI , -0.22 to 1.27 ) and depression ( 12.67 [ 3.27 ] vs 12.49 [ 3.34 ] ; AMD , 0.17 , 95 % CI , -0.54 to 0.89 ) . After 3 months of treatment , the intervention group had significantly lower mean ( SD ) HADS scores than the control group for anxiety ( 7.25 [ 3.63 ] vs 10.03 [ 3.87 ] ; AMD , -2.77 ; 95 % CI , -3.56 to -1.98 ) and depression ( 6.30 [ 3.40 ] vs 9.27 [ 3.56 ] ; AMD , -2.98 ; 95 % CI , -3.74 to -2.22 ) . At 3 months , there were also significant differences in scores of posttraumatic stress ( AMD , -5.86 ; 95 % CI , -8.53 to -3.19 ) , functional impairment ( AMD , -4.17 ; 95 % CI , -5.84 to -2.51 ) , problems for which the person sought help ( AMD , -1.58 ; 95 % CI , -2.40 to -0.77 ) , and symptoms of depressive disorder ( AMD , -3.41 ; 95 % CI , -4.49 to -2.34 ) . Conclusions and Relevance Among adults impaired by psychological distress in a conflict-affected area , lay health worker administration of a brief multicomponent intervention based on established behavioral strategies , compared with enhanced usual care , result ed in 
    Output:
    
Overall , MHPSS programmes show benefits in improved functioning and reducing post-traumatic stress disorder .
There are also indications from a limited pool of evidence that cognitive-behavioural therapy and narrative exposure therapy may improve mental health conditions .
Other psychotherapy modalities also showed a positive trend in favour of MHPSS programmes for improving several mental health outcomes .