Cognitive Behavioral Therapy for Prodromal Stage of Psychosis-Outcomes for Transition, Functioning, Distress, and Quality of Life: A Systematic Review and Meta-analysis
Autor: | Yuchen Zheng, Chunbo Li, Steven Livingstone, Tingting Xu, Yikang Zhu, Tianhong Zhang, Jijun Wang |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Psychosis medicine.medical_treatment Prodromal Symptoms law.invention 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial law Internal medicine Outcome Assessment Health Care medicine Humans Cognitive Behavioral Therapy business.industry Prodromal Stage medicine.disease 030227 psychiatry Cognitive behavioral therapy Psychiatry and Mental health Distress Editorial Psychotic Disorders Relative risk Meta-analysis Disease Progression Quality of Life business 030217 neurology & neurosurgery |
Zdroj: | Schizophr Bull |
ISSN: | 1745-1701 |
Popis: | Objective This study aimed to provide insight into the efficacy of cognitive-behavioral therapy for psychosis (CBTp) in patients with “clinical high risk of psychosis (CHR-P)”. Methods Major scientific databases were searched up to April 17, 2020. Randomized controlled trials in CHR-P individuals, comparing CBTp with needs-based interventions (NBI, including treatment as usual or nonspecific control treatment) were included, following PRISMA guidelines. The primary outcome (efficacy) was transition to psychosis by 6 months, 12 months, 24 months, and over 24 months. Secondary outcomes were change in attenuated psychotic symptoms, depression, distress, improvements in functioning, and quality of life. Results Ten randomized controlled studies met inclusion criteria. The comparisons included 1128 participants. CBTp was significantly more efficacious in reducing rate of transition to psychosis by 6 months (after post-hoc sensitivity analysis) (relative risk [RR] = 0.44, 95% confidence interval [CI]: 0.26, 0.73), 12 months (RR = 0.44, 95% CI: 0.30, 0.64), 12 months (RR = 0.46, 95%CI: 0.30, 0.69), and over 24 months (RR = 0.58, 95% CI: 0.35, 0.95) after treatment, compared with those receiving NBI. CBTp was also associated with more reduced attenuated psychotic symptoms by 12 months (SMD = −0.17, 95% CI: −0.33, −0.02) and by 24 months (SMD = −0.24, 95% CI: −0.43, −0.06). No beneficial effects on functioning, depression, quality of life, or distress were observed favoring CBTp. Conclusions CBTp is effective in reducing both psychosis transition rates and attenuated psychotic symptoms for the prodromal stage of psychosis. It is a promising intervention at the preventative stage. |
Databáze: | OpenAIRE |
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