The effectiveness of culturally adapted cognitive behavioral intervention in reducing psychological distress of COVID-19 survivors

Survivors of the infectious diseases are at an increased risk of mental problems both in the short- and long-term, as observed in the epidemics of the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS) as well as the novel coronavirus disease (COVID-19). However, to our knowledge, there is a dearth of high-quality research investigating the effectiveness of mental health interventions targeting psychological problems of COVID-19 survivors. We, therefore, conducted a randomized controlled trial (RCT) to investigate whether the online-delivered, group-based culturally adapted cognitive behavioral intervention (CA-CBI) would be effective in improving the levels of psychological distress in addition to a range of secondary outcomes in COVID-19 survivors at a one-month follow-up assessment. 34 participants with elevated levels of psychological distress were randomly assigned to CA-CBI or enhanced treatment as usual (ETAU). In the intention-to-treat analysis, we found that the CA-CBI significantly improved depressive symptoms (d = 0.8) and environmental quality of life (d = 0.8) over ETAU at the one-month follow-up. While within-group differences were observed in psychological distress, anxiety, post-traumatic stress symptoms, and psychological quality of life in favor of the intervention group, no differences were detected for somatic symptoms, and quality of life related to physical health and social relationships. Considering that the study was not powered to detect significant effects on each outcome measure, these results suggest that CA-CBI seems to be promising in improving the mental health problems of survivors of infectious diseases. In the future, the findings should be tested with fully powered RCTs. Key Words: COVID-19 survivors, psychological distress, culturally adapted cognitive behavioral intervention, mental health intervention