Cultural adaptation and randomised evaluation of a multi-component school- based intervention for common mental disorders in Pakistani adolescents

我们目前正与世界卫生组织合作，在包括巴基斯坦在内的东地中海地区的一些国家实施学校心理健康。这一大规模方案与卫生部和教育部合作，力求对学校环境中的儿童和青少年实施循证干预。包括教师和卫生保健提供者在内的主要利益攸关方发现，有大量未得到满足的需求需要有针对性的干预措施，以解决年龄较大青少年的高度焦虑和抑郁问题。作为回应，世卫组织在与国际专家磋商并对现有证据进行审查后，开发了一种名为青春期早期情绪技能(EASE)的简短跨诊断干预措施。这一简短的团体心理干预是基于认知行为疗法(CBT)，该疗法被认为可以治疗年轻人的焦虑和抑郁。这种干预旨在由非专业人员在低资源环境下提供。该项目的目的是对巴基斯坦正在进行的学校心理健康方案进行调整，使之更加容易，以满足有抑郁和焦虑症状的青少年的需要。在此之后，我们将进行一项研究，看看与没有接受干预的14-16岁在校青少年相比，接受干预的14-16岁在校青少年在改善焦虑和抑郁症状方面是否有效。我们还将评估将此类干预融入巴基斯坦学校系统的成本、障碍和促进者。

We are currently working with the WHO to implement school mental health in a number of countries in the Eastern Mediterranean region, including Pakistan. This large-scale programme in collaboration with Ministries of Health and Education seeks to implement evidence-based interventions for children and adolescents in school-settings. The key stakeholders, including teachers and health-care providers, have identified a large unmet need for a targeted intervention to address high levels of anxiety and depression in older adolescents. In response, the WHO after consultation with international experts, and conducting a review of available evidence, have developed a brief transdiagnostic intervention called Early Adolescence Skills for Emotions (EASE). This brief group psychological intervention is based on cognitive behavioural therapy (CBT) recognised to treat anxiety and depression in young people. The intervention is designed to be delivered by non-specialists in low resource settings. The aim of this project is to adapt and add EASE to the ongoing school mental health programme in Pakistan to address the needs of adolescents with symptoms of depression and anxiety. Following this, we will conduct a study to see if the intervention is effective in improving symptoms of anxiety and depression in school-going adolescents aged 14-16 who receive the intervention, compared to those who don't. We will also evaluate the costs, and barriers and facilitators of integrating such an intervention into the Pakistani school system.