Randomised clinical trial investigating memory training for recovery-adolescents in addressing psychiatric concerns among adolescents in Iraq

Background

‍ In this randomised clinical trial, the authors investigated the efficacy of Memory Training for Recovery-Adolescent (METRA) in improving psychiatric symptoms among adolescents in Iraq.

Methods

‍In the study, adolescents aged 10–19 years with heightened psychiatric distress living in Kirkuk were included. It was a parallel-group trial comparing METRA with treatment as usual (TAU), with a three-month follow-up. The study occurred between July 2023 and January 2024. Participants assigned to METRA received a 10-session group intervention comprised of memory specificity training and writing for recovery. Assessments occurred at baseline, post-intervention, and three months after treatment. Primary outcome measures were self-reported post-traumatic stress disorder (PTSD) and depression symptoms post-intervention. Secondary outcomes were measures of anxiety and psychiatric difficulties. The study also examined the costs and affordability of METRA in a humanitarian context. The sample size for primary analyses included 67 adolescents in the METRA group and 65 adolescents in TAU.

Results

‍Following the intention-to-treat principle, linear mixed-effects models found that at post-intervention the METRA group had a 10.96-point decrease (95% confidence interval (CI) = -13.82, -8.09) in PTSD symptoms and a 3.27-point decrease (95% CI = -4.67, -1.87) in depression symptoms. Improvements were maintained at the three-month follow-up. While the time main effects were significant (P < 0.001), the group × time interactions were not significant (P = 0.61 for PTSD and P = 0.71 for depression); thus, there was no evidence that these improvements were superior to the symptom improvements observed in TAU.

Conclusions

‍In this study, the authors found that while METRA was not more effective than TAU, it was less costly, offering an option for replacing current practice. The findings highlight a need for further research in this area of global mental health.

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