Abstract
QUESTION: Mental health complaints are increased in survivors of natural hazards and disaster responders. This meta-analysis assessed the efficacy of psychological and psychosocial interventions for the prevention of mental disorders after exposure to natural hazards. STUDY SELECTION AND ANALYSIS: We searched Web of Science, PsycINFO and MEDLINE for peer-reviewed randomised controlled trials evaluating preventive interventions targeting symptoms of post-traumatic stress disorder, depression and anxiety. Trials conducted in both, civilians and disaster responders, were included. Random-effect meta-analyses were conducted to assess the efficacy of interventions relative to active and passive control conditions. FINDINGS: The results from 10 included studies (5068 participants) did not find preventive interventions to be superior compared with active or passive control conditions regarding symptoms of post-traumatic stress disorder (g=0.08 and g=0.05) and depression (g=0.13 and g=0.32, respectively). Effects on anxiety symptoms remain unclear. Aggregated effects for all outcomes were significant at follow-up compared with passive controls, but the interpretability is limited by the low number of studies. Intervention effects were not significantly associated with intervention type (psychotherapy vs psychosocial), age or delivery mode (online vs face-to-face). The risk of bias across studies was high. CONCLUSIONS: The current evidence does not allow for any recommendations regarding prevention programmes in the aftermath of natural hazards. A larger body of high-quality research is needed to develop effective and evidence-based preventive interventions for disaster survivors and responders. STUDY REGISTRATION: https://osf.io/4es65.