Facilitating and hindering factors in the treatment of persistent somatic symptoms in migrants: A scoping review

Objective: To identify facilitating and hindering factors in the treatment of persistent somatic symptoms (PSS) in migrants in psychiatry and other health care settings in Western countries. Methods: A scoping literature review was conducted by searching PubMed and Embase, using combinations of search terms related to the treatment of PSS in migrants. Studies outside of the scope of current guidelines or limited to specific underlying diseases such as post-traumatic stress disorder (PTSD) or consequences of torture were excluded. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies, and identified and categorized facilitating and hindering treatment factors. Results: Of the 347 unique citations identified in the initial the search, 18 studies met the inclusion criteria. These studies showed a wide variety in study design, interventions used, measurement instruments, and study quality. Common treatment adaptations related to: (a) translation and interpretation, (b) adaptation to lower educational levels, (c) culture-sensitive therapists and materials, (d) gender roles, (e) removal of practical barriers, (f) supportive treatment, and (g) nonverbal therapy forms. The most commonly mentioned influencing factors of treatment success related to: (a) body and experience-oriented treatment elements, (b) translation and communication, (c) cultural sensitivity, (d) group interaction, and (e) caring for one's own health. Conclusion: This review provides an overview of available research on treatment adaptations for PSS in migratory background patients. Potential facilitating and hindering factors for treatment success that may be useful for healthcare providers treating PSS in patients with a migratory background were identified.