Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy

Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy

2002 | S. PILLING, P. BEBBINGTON, E. KUIPERS, P. GARETY, J. GEDDES, G. ORBACH AND C. MORGAN
This meta-analysis evaluates the effectiveness of family intervention and cognitive behaviour therapy (CBT) in schizophrenia. Family intervention, particularly single family therapy, showed clear preventative effects on psychotic relapse and readmission, as well as benefits in medication compliance. CBT produced higher rates of 'important improvement' in mental state and had positive effects on continuous measures of mental state at follow-up. CBT also had low drop-out rates. The study concludes that family intervention should be offered to people with schizophrenia in contact with carers, and CBT may be useful for those with treatment-resistant symptoms. Both treatments should be further investigated in large trials across various settings. The factors mediating treatment success in these interventions should be researched. The analysis of psychological interventions in schizophrenia was conducted by a joint working party of the British Psychological Society and Royal College of Psychiatrists. It draws on the Cochrane methodology with modifications. The study included randomized controlled trials (RCTs) providing comparisons with standard care or other active interventions. The analysis of data used intention-to-treat analysis, and dichotomous outcomes were analyzed using odds ratios. Continuous data were analyzed using effect sizes. The study found that family interventions, particularly single family therapy, were more effective in reducing relapse and readmission compared to other treatments. CBT showed consistent benefits in terms of mental state, with a clear advantage over other treatments on the measure of 'important improvement' in mental state. CBT had lower drop-out rates than standard care. The study also found that family interventions had lower rates of treatment non-compliance compared to other active treatments, and increased medication compliance. However, there was no difference in suicide rates between family interventions and other treatments. The study found that the effectiveness of family interventions was not associated with specific patient or family characteristics. Similarly, the effectiveness of CBT was not associated with specific patient characteristics or the frequency and duration of treatment. The study concluded that both family intervention and CBT are potentially effective treatments for schizophrenia, but further research is needed to refine the treatment and identify the most effective components and methods of delivery. The findings suggest that CBT should be made more generally available in secondary care mental health services to offer a greater choice of psychosocial interventions for sufferers and their carers.This meta-analysis evaluates the effectiveness of family intervention and cognitive behaviour therapy (CBT) in schizophrenia. Family intervention, particularly single family therapy, showed clear preventative effects on psychotic relapse and readmission, as well as benefits in medication compliance. CBT produced higher rates of 'important improvement' in mental state and had positive effects on continuous measures of mental state at follow-up. CBT also had low drop-out rates. The study concludes that family intervention should be offered to people with schizophrenia in contact with carers, and CBT may be useful for those with treatment-resistant symptoms. Both treatments should be further investigated in large trials across various settings. The factors mediating treatment success in these interventions should be researched. The analysis of psychological interventions in schizophrenia was conducted by a joint working party of the British Psychological Society and Royal College of Psychiatrists. It draws on the Cochrane methodology with modifications. The study included randomized controlled trials (RCTs) providing comparisons with standard care or other active interventions. The analysis of data used intention-to-treat analysis, and dichotomous outcomes were analyzed using odds ratios. Continuous data were analyzed using effect sizes. The study found that family interventions, particularly single family therapy, were more effective in reducing relapse and readmission compared to other treatments. CBT showed consistent benefits in terms of mental state, with a clear advantage over other treatments on the measure of 'important improvement' in mental state. CBT had lower drop-out rates than standard care. The study also found that family interventions had lower rates of treatment non-compliance compared to other active treatments, and increased medication compliance. However, there was no difference in suicide rates between family interventions and other treatments. The study found that the effectiveness of family interventions was not associated with specific patient or family characteristics. Similarly, the effectiveness of CBT was not associated with specific patient characteristics or the frequency and duration of treatment. The study concluded that both family intervention and CBT are potentially effective treatments for schizophrenia, but further research is needed to refine the treatment and identify the most effective components and methods of delivery. The findings suggest that CBT should be made more generally available in secondary care mental health services to offer a greater choice of psychosocial interventions for sufferers and their carers.
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