Science Portal
v2.1.6224.produseast1
Copyright © Médecins Sans Frontières
v2.1.6224.produseast1
BACKGROUND
Survivors of torture and ill-treatment (SOITs) among forcibly displaced populations have complex mental health needs, yet evidence on treatment predictors and optimal duration in humanitarian settings remains limited. This study examined predictors of treatment outcomes and adherence among SOITs attending a comprehensive care centre (CAI) for migrants and refugees in Mexico.
METHODS
We conducted a retrospective cohort study using routinely collected clinical data from 672 SOITs enrolled in the MSF CAI mental health programme in Mexico City (2019–2025). Outcomes were assessed using the Clinical Global Impression of Improvement (CGI-I) and Mental Health Global State (MHGS) scales. Multivariable logistic regression identified predictors of improvement and loss to follow-up (LTFU). Time to improvement was analysed using Kaplan–Meier and Cox proportional hazards models. Among responders, negative binomial regression identified factors associated with sessions needed for improvement.
RESULTS
Baseline clinical severity negatively predicted CGI-I improvement (OR = 0.48; 95% CI 0.27–0.87), while treatment exposure showed a dose–response relationship, with higher improvement beyond three sessions. Children (≤ 15 years) improved faster than adults (HR = 1.37; 95% CI 1.03–1.82), while PTSD diagnosis and severe symptoms were associated with slower improvement and more sessions needed. LTFU was more likely among those with severe baseline symptoms and LGBTQ+ individuals, while younger age and treatment exposure were protective.
CONCLUSIONS
SOITs present heterogeneous therapeutic needs, with response profiles ranging from faster (≈ 11 sessions) to very slow responders (22–23 sessions). Baseline severity, PTSD diagnosis, and age predicted both outcomes and LTFU risk. Retention emerges as a key modifiable leverage point for mental health service design in SOIT populations.