What question did this study set out to answer?

The aim was to evaluate the feasibility of Problem Management Plus and its effectiveness in reducing mental health issues among earthquake survivors in Türkiye.

June 17, 2026

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Problem Management Plus for improving mental health among earthquake-affected individuals in Türkiye: pilot randomised controlled trial.

ATAyşenur Coşkun TokerKoç University GKG KurtAmerican Academy of Child and Adolescent Psychiatry GMGökhan MalkoçIstanbul Medipol University

Key Points

The aim was to evaluate the feasibility of Problem Management Plus and its effectiveness in reducing mental health issues among earthquake survivors in Türkiye.
Pilot randomized controlled trial with 38 participants.
Primary outcome focused on depression using the PHQ-9; assessed at baseline, 1 week post intervention, and at 1-month follow-up.
Secondary outcomes included measures of psychological distress, anxiety, functional impairment, and post-traumatic stress.
Recruitment and retention rates were 74% and treatment adherence was 79%, indicating feasibility.
PM+ led to significant reductions in PHQ-9 (-5.91, 95% CI -8.23 to -3.58) and other mental health outcomes compared to the control group.
Improvements in psychological distress and self-identified problems remained significant at follow-up.

Abstract

BACKGROUND: Earthquakes present significant threats to community mental health, yet post-disaster resource limitations and high demand restrict access to care. The 2023 Türkiye-Syria earthquakes affected millions, increasing psychological problems and highlighting the urgent need for scalable interventions. AIMS: This study assessed (a) the feasibility of procedures prior to a fully powered randomised controlled trial (RCT) and (b) the potential effectiveness of Problem Management Plus (PM+), a scalable psychological intervention, in reducing common mental health problems among Turkish earthquake survivors. METHOD: = 38) and assessed at baseline, 1 week post intervention and at the 1-month follow-up. The primary outcome was depression (Patient Health Questionnaire, PHQ-9); secondary outcomes were self-identified problems (Psychological Outcome Profiles, PSYCHLOPS), functional impairment (World Health Organization Disability Assessment Schedule, WHODAS 2.0), psychological distress (Kessler-10 Psychological Distress Scale, K-10), anxiety (Generalised Anxiety Disorder Scale, GAD-7) and post-traumatic stress (Post-traumatic Stress Disorder Checklist, PCL-5). The trial was prospectively registered (NCT06026306). RESULTS: Recruitment, retention (74%) and treatment adherence (79%) supported feasibility. At post-assessment, PM+ showed greater reductions than E-CAU across all outcomes: PHQ-9 (adjusted mean difference -5.91, 95% CI -8.23 to -3.58), PSYCHLOPS (-6.94, -8.88 to -5.01), WHODAS 2.0 (-8.77, -12.50 to -5.03), K-10 (-9.66, -13.35 to -5.97), GAD-7 (-4.31, -6.39 to -2.24) and PCL-5 (-18.72, -25.97 to -11.47). At follow-up, improvements remained significant for psychological distress and self-identified problems. CONCLUSIONS: Findings provide preliminary evidence that PM+ is a feasible and potentially effective intervention for alleviating common mental health problems among Turkish earthquake survivors.

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Problem Management Plus for improving mental health among earthquake-affected individuals in Türkiye: pilot randomised controlled trial.

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