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

J Glob Health. 2025 May 5;15:04111. doi: 10.7189/jogh.15.04111.

ABSTRACT

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

METHODS: In the study, we included adolescents aged 10-19 years with heightened psychiatric distress living in Kirkuk. 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 posttraumatic stress disorder (PTSD) and depression symptoms post-intervention. Secondary outcomes were measures of anxiety and psychiatric difficulties. We 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 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, we 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.

REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12622001413718).

PMID:40319505 | DOI:10.7189/jogh.15.04111