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The Capital Region of Denmark - a part of Copenhagen University Hospital

Danish Database on Refugees with Trauma (DART) - Improving mental health care for trauma-affected refugees

Project: Types of projectsProject

  • Vindbjerg, Erik (Project Manager, academic)
  • Carlsson, Jessica Mariana (Project Manager, organisational)
  • Mortensen, Erik Lykke (Project participant)
  • Silove, Derrick , Australia (Project participant)
  • Karstoft, karen-Inge, Veterancenteret, Denmark (Project participant)
  • Benros, Michael Eriksen (Project participant)
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Introduction:
Previous studies have found psychiatric interventions for trauma-affected refugees to demonstrate limited treatment response. While still inadequatly adressed in the litterature, impediments to treatment outcome may include chronicity—e.g. reflected in duration of symptoms and previous treatment attempts—and comorbid pain. Chronicity may be reflected in other factors, such as medicine at referral, although this has not been assessed for this population.
The understanding of predictors of treatment is vital to optimizing treatment effectiveness, allowing us to retain existing treatment for responders and tayloring treatment better to the needs of non-responders. Accordingly, the current project aims to provide thorough characterisations of both responders and non-responders to previous interventions. Based on a uniqely compresensive database along with machine learning methods to optimize the explained variance, the study allows for both a more accurate identification of responders and a more informative characterization of non-responders.

Methods:
Data for this project are pooled across five previous randomized controlled trials (RCTs) at the Competence Centre for Transcultural Psychiatry (CTP). The five RCTs have tested specific hypotheses about pharmaco-, psycho-, and physiotherapy. All RCTs were designed to allow future pooling. Thus, all have identical a) inclusion criteria, b) primary and secondary outcome measures, c) registration of traumatic exposure, post-migratory difficulties, social service utilization, comorbid diagnoses, demographic information (among many other characteristics), as well as d) four identical points of assessment (T1-T4).
From 2009-2019, 80- 90% of the CTP’s trauma-affected refugee patients have been included in the RCTs. Thus, the full spectrum of cultural, socio-economic, and symptom diversity of a trauma-affected refugee patient population, in a western clinic, is represented. As the trials were carried out sequentially, with identical inclusion criteria, the pooled database can be considered as one population, with participants randomized to several treatments.

Expected Results:
We expect that different responses can be predicted by demographic and post-migratory characteristics, severity and type of traumatic exposure, comorbidity at baseline, as well as treatment- and service-use characteristics. Based on the results of our RCT’s, we also expect patient characteristics to be stronger predictors of treatment response than the variations in drug- and psychotherapy across the five RCTs.

Expected Impact:
Given sufficent predictive accuracy, results will serve for selection of patient to more adapted interventions in future intervention studies. While some patients will be selected for conventional interventions, such as trauma-focused therapy, others may be served with more specialised interventions, while yet others may not benefit beyond basic psychoeducation and techniques for arousal regulation.



StatusCurrent
Period01/10/201731/12/2022

    Research areas

  • Health Sciences - Transcultural Psychiatry, Randomized Controlled Clinical Trial, Observational Study

ID: 59656692