Evidence map›Paper›PMID 32462893›Full record

SynthesisThe Australian and New Zealand journal of psychiatry2020

Psychological interventions for people with psychotic experiences: A systematic review and meta-analysis of controlled and uncontrolled effectiveness and economic studies.

Emma Soneson, Debra Russo, Jan Stochl, Margaret Heslin, Julieta Galante, Clare Knight, Nick Grey, Joanne Hodgekins, Paul French, David Fowler and 4 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Australian and New Zealand journal of psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

14 authors.

Emma SonesonDepartment of Psychiatry, University of Cambridge, Cambridge, UK.ORCID 0000-0003-1666-3012
Debra RussoDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Jan StochlDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Margaret HeslinPopulation Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Julieta GalanteDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Clare KnightDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Nick GreySussex Partnership NHS Foundation Trust, Hove, UK.
Joanne HodgekinsDepartment of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
Paul FrenchPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
David FowlerSchool of Psychology, University of Sussex, Brighton, UK.
Louise LafortuneDepartment of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
Sarah ByfordPopulation Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Peter B JonesDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Jesus PerezDepartment of Psychiatry, University of Cambridge, Cambridge, UK.

Funding

Department of Health RP-PG-0616-20003Wellcome Trust
6 · The paper itself

Abstract

objectiveMany people with psychotic experiences do not develop psychotic disorders, yet those who seek help demonstrate high clinical complexity and poor outcomes. In this systematic review and meta-analysis, we evaluated the effectiveness and cost-effectiveness of psychological interventions for people with psychotic experiences.

methodWe searched 13 databases for studies of psychological interventions for adults with psychotic experiences, but

resultsA total of 27 reports met inclusion criteria. In general, there was no strong evidence for the superiority of any one intervention. Five studies reported on our primary outcome, though only two reports provided randomised controlled trial evidence that psychological intervention (specifically, cognitive behavioural therapy) promoted remission from psychotic experiences. For secondary outcomes, we could only meta-analyse trials of cognitive behavioural therapy. We found that cognitive behavioural therapy was more effective than treatment as usual for reducing distress (pooled standardised mean difference: -0.24; 95% confidence interval = [-0.37, -0.10]), but no more effective than the control treatment for improving any other outcome. Individual reports indicated that cognitive behavioural therapy, mindfulness-based cognitive therapy, sleep cognitive behavioural therapy, systemic therapy, cognitive remediation therapy, and supportive treatments improved at least one clinical or functional outcome. Four reports included economic evaluations, which suggested cognitive behavioural therapy may be cost-effective compared with treatment as usual.

conclusionOur meta-analytic findings were primarily null, with the exception that cognitive behavioural therapy may reduce the distress associated with psychotic experiences. Our analyses were limited by scarcity of studies, small samples and variable study quality. Several intervention frameworks showed preliminary evidence of positive outcomes; however, the paucity of consistent evidence for clinical and functional improvement highlights a need for further research into psychological treatments for psychotic experiences. PROSPERO PROTOCOL REGISTRATION NUMBER: CRD42016033869.

Indexed as

Life Change EventsClinical Trials as TopicCognitive Behavioral TherapyHumansPsychotic Disordersat-risk mental statepsychological interventionPsychosispsychotic experiencesultra-high risk

Identifiers

PMID32462893
PMCPMC7324911

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.