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Problem Management Plus (PM+) for common mental disorders in a humanitarian setting in Pakistan; study protocol for a randomised controlled trial (RCT)

Sijbrandij, Marit; Farooq, Saeed; Bryant, Richard A.; Dawson, Katie; Hamdani, Syed Usman; Chiumento, Anna; Minhas, Fareed; Saeed, Khalid; Rahman, Atif; van Ommeren, Mark


Marit Sijbrandij

Richard A. Bryant

Katie Dawson

Syed Usman Hamdani

Anna Chiumento

Fareed Minhas

Khalid Saeed

Atif Rahman

Mark van Ommeren


In humanitarian settings common mental disorders (depression, anxiety disorders, posttraumatic stress disorder) are highly prevalent. The World Health Organization (WHO) has developed Problem Management Plus (PM+), a 5-session, individual psychological intervention program, delivered by paraprofessionals that addresses common mental disorders in people in communities affected by adversity. The objectives of this study are to test effectiveness and cost-effectiveness of the locally adapted PM+ compared to Treatment as usual (TAU) in Peshawar District, Pakistan.

A randomised controlled trial will be conducted in 346 primary care attendees in 3 health care centres in Peshawar District, Pakistan. After informed consent, primary care attendees with high levels of psychological distress according to the General Health Questionnaire-12 (GHQ-12) and functional impairment (WHO Disability Assessment Schedule 2.0 (WHODAS)) will be assigned to PM+ (n = 173) or TAU (n = 173). At baseline, 1 week and 3 months following PM+, independent assessors will assess psychological distress with the Hospital Anxiety and Depression Scale (HADS), and functional disability with the WHODAS. Secondary outcomes are posttraumatic stress disorder (PTSD) symptoms, and client-perceived priority problems. Further, cost-effectiveness will be assessed using the Service Receipt Inventory (SRI).

If proven effective, PM+ will be rolled out to other areas for further adaptation and testing in diverse humanitarian settings.


Sijbrandij, M., Farooq, S., Bryant, R. A., Dawson, K., Hamdani, S. U., Chiumento, A., …van Ommeren, M. (2015). Problem Management Plus (PM+) for common mental disorders in a humanitarian setting in Pakistan; study protocol for a randomised controlled trial (RCT). BMC Psychiatry, 15(1), Article 232.

Journal Article Type Article
Acceptance Date Sep 9, 2015
Online Publication Date Oct 1, 2015
Publication Date 2015-12
Deposit Date Nov 30, 2023
Journal BMC Psychiatry
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 15
Issue 1
Article Number 232
Keywords Psychiatry and Mental health
Additional Information Received: 28 July 2015; Accepted: 9 September 2015; First Online: 1 October 2015; Change Date: 15 October 2018; Change Type: Correction; Change Details: Following publication of the original article [1], the first author reported an error in referring his paper.