Evidence map›Paper›PMID 17962231›Full record

SynthesisSchizophrenia bulletin2008

Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor.

Til Wykes, Craig Steel, Brian Everitt, Nicholas Tarrier

2 registry-linked trialsAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Schizophrenia bulletin, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 268 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
268citing papers in PubMed, 25 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01876056 nacompletednot on this mapstarted 2013, after this paper: background citation

A Randomized Controlled Trial of Brief Culturally Adapted CBT for Schizophrenia in Pakistan

TypeinterventionalSponsorPakistan Association of Cognitive TherapistsRan2013 to 2014Enrolled120ConditionsSchizophreniaArmsBrief CaCBTp
NCT02254733 nacompletednot on this mapstarted 2012, after this paper: background citation

Enhancing Assertive Community Treatment With Cognitive Behavioral Therapy and Social Skills Training for Schizophrenia.

TypeinterventionalSponsorVeterans Medical Research FoundationRan2012 to 2016Enrolled178ConditionsSchizophreniaArmsCognitive Behavioral Social Skills Training (CBSST), Assertive Community Treatment (ACT)
3 · Its place in the literature

Who cites it

268 citing papers in PubMed, 25 syntheses or guidelines pooled it.

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  6. Cognitive behavioural therapy without medication for schizophrenia.The Cochrane database of systematic reviews · 2024
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  13. Schizophrenia.Deutsches Arzteblatt international · 2020
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  16. Self-management interventions for people with severe mental illness: systematic review and meta-analysis.The British journal of psychiatry : the journal of mental science · 2019
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208 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Til WykesDepartment of Psychology, Institute of Psychiatry, King's College London, London, UK. t.wykes@iop.kcl.ac.uk
Craig Steel
Brian Everitt
Nicholas Tarrier

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidance in the United States and United Kingdom has included cognitive behavior therapy for psychosis (CBTp) as a preferred therapy. But recent advances have widened the CBTp targets to other symptoms and have different methods of provision, eg, in groups.

aimTo explore the effect sizes of current CBTp trials including targeted and nontargeted symptoms, modes of action, and effect of methodological rigor.

methodThirty-four CBTp trials with data in the public domain were used as source data for a meta-analysis and investigation of the effects of trial methodology using the Clinical Trial Assessment Measure (CTAM).

resultsThere were overall beneficial effects for the target symptom (33 studies; effect size = 0.400 [95% confidence interval [CI] = 0.252, 0.548]) as well as significant effects for positive symptoms (32 studies), negative symptoms (23 studies), functioning (15 studies), mood (13 studies), and social anxiety (2 studies) with effects ranging from 0.35 to 0.44. However, there was no effect on hopelessness. Improvements in one domain were correlated with improvements in others. Trials in which raters were aware of group allocation had an inflated effect size of approximately 50%-100%. But rigorous CBTp studies showed benefit (estimated effect size = 0.223; 95% CI = 0.017, 0.428) although the lower end of the CI should be noted. Secondary outcomes (eg, negative symptoms) were also affected such that in the group of methodologically adequate studies the effect sizes were not significant.

conclusionsAs in other meta-analyses, CBTp had beneficial effect on positive symptoms. However, psychological treatment trials that make no attempt to mask the group allocation are likely to have inflated effect sizes. Evidence considered for psychological treatment guidance should take into account specific methodological detail.

Indexed as

Cognitive Behavioral TherapyHumansPsychometricsSchizophrenia

Identifiers

PMID17962231
PMCPMC2632426

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.