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Mc Glanaghy E, Turner D, Davis GA, Sharpe H, Dougall N, Morris P, Prentice W, Hutton P. A network meta-analysis of psychological interventions for schizophrenia and psychosis: Impact on symptoms. Schizophr Res 2021; 228:447-459. [PMID: 33578368 DOI: 10.1016/j.schres.2020.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/30/2020] [Accepted: 12/30/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Evidence for the effectiveness of psychological interventions for schizophrenia/psychosis is growing, however there is no consensus on the psychological intervention most likely to reduce symptoms. METHODS A network meta-analysis was conducted to identify all randomised controlled trials (RCTs) of psychological interventions for adults with schizophrenia/psychosis. A systematic review of the literature using MEDLINE, PsycINFO, EMBASE and CENTRAL led to an analysis of 90 RCTs with 8440 randomised participants across 24 psychological intervention, and control groups. Psychological interventions were categorised and rated for treatment fidelity and risk of bias. Data for total symptoms were extracted and network meta-analysis, using a frequentist approach, was undertaken using Stata SE v15 to compare the direct and indirect evidence for the effectiveness of each psychological intervention. FINDINGS Psychological interventions were more likely to reduce symptoms than control groups, and one intervention, mindfulness-based psychoeducation, was consistently ranked as most likely to reduce total symptoms. Subgroup analyses identified differential effectiveness in different settings and for different subgroups. INTERPRETATION Mindfulness-based psychoeducation was consistently ranked as most likely to reduce symptoms; however all studies were based in China. More RCTs in a variety of cultural contexts would help to elucidate whether these findings generalise internationally. A number of psychological interventions could potentially be more effective than interventions recommended by NICE guidelines, such as CBT and family therapy, and additional RCTs and meta-analyses are needed to generate more conclusive evidence in this regard.
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Affiliation(s)
- Edel Mc Glanaghy
- School of Health in Social Science, University of Edinburgh, UK; School of Health and Social Care, Edinburgh Napier University, UK; NHS Forth Valley, UK.
| | | | - Georgina A Davis
- School of Health and Social Care, Edinburgh Napier University, UK
| | - Helen Sharpe
- School of Health in Social Science, University of Edinburgh, UK
| | - Nadine Dougall
- School of Health and Social Care, Edinburgh Napier University, UK
| | - Paul Morris
- School of Health in Social Science, University of Edinburgh, UK
| | | | - Paul Hutton
- School of Health and Social Care, Edinburgh Napier University, UK
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Turkington D, Spencer H, Lebert L, Dudley R. Befriending: active placebo or effective psychotherapy? Br J Psychiatry 2017; 211:5-6. [PMID: 28673943 DOI: 10.1192/bjp.bp.116.197467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/29/2017] [Indexed: 11/23/2022]
Abstract
Befriending allows for control of the non-specific factors of the therapist-patient interaction in psychosocial research. Manualised befriending is at the very least an active placebo and potentially an effective intervention. Befriending now merits increased research attention to determine indications for use and to elucidate mechanisms of action.
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Affiliation(s)
- Douglas Turkington
- Douglas Turkington, MD, FRCPsych, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and Institute of Neuroscience, Newcastle University; Helen Spencer, BA, Latoyah Lebert, BSc, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University; Robert Dudley, PhD, DCIinPsy, Early Intervention in Psychosis Service, Tranwell Unit, Queen Elizabeth Hospital, Gateshead, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University, UK
| | - Helen Spencer
- Douglas Turkington, MD, FRCPsych, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and Institute of Neuroscience, Newcastle University; Helen Spencer, BA, Latoyah Lebert, BSc, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University; Robert Dudley, PhD, DCIinPsy, Early Intervention in Psychosis Service, Tranwell Unit, Queen Elizabeth Hospital, Gateshead, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University, UK
| | - Latoyah Lebert
- Douglas Turkington, MD, FRCPsych, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and Institute of Neuroscience, Newcastle University; Helen Spencer, BA, Latoyah Lebert, BSc, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University; Robert Dudley, PhD, DCIinPsy, Early Intervention in Psychosis Service, Tranwell Unit, Queen Elizabeth Hospital, Gateshead, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University, UK
| | - Robert Dudley
- Douglas Turkington, MD, FRCPsych, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and Institute of Neuroscience, Newcastle University; Helen Spencer, BA, Latoyah Lebert, BSc, Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle General Hospital, Newcastle upon Tyne, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University; Robert Dudley, PhD, DCIinPsy, Early Intervention in Psychosis Service, Tranwell Unit, Queen Elizabeth Hospital, Gateshead, Northumberland, Tyne and Wear NHS Mental Health Foundation Trust, and School of Psychology, Newcastle University, UK
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