Evidence map›Paper›PMID 41063577›Full record

SynthesisEuropean psychiatry : the journal of the Association of European Psychiatrists2025

The effectiveness of non-pharmacological treatments for auditory verbal hallucinations in schizophrenia spectrum disorders: A systematic review and meta-analysis.

Melis Cobandag, Natasha Sigala

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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

2 authors.

Melis CobandagDepartment of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.ORCID 0009-0001-9326-6769
Natasha SigalaDepartment of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.ORCID 0000-0002-9456-6093

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSchizophrenia is a chronic severe mental illness affecting 24-million people globally, associated with a life expectancy 15 years shorter than the general population. Approximately 70% of people with schizophrenia experience auditory verbal hallucinations (AVHs), i.e. 'hearing voices'. Current treatment approaches remain unsuccessful in up to 30% of cases.

aimsThis systematic review and meta-analysis evaluated randomised controlled trials (RCTs) of non-pharmacological treatments for AVHs in schizophrenia spectrum disorders, assessing emerging treatment effectiveness and identifying research gaps.

methodsA literature search was performed between 2013-2024 across five databases: PubMed, Embase, PsycINFO, Medline, and Web of Science. The meta-analysis included 45 studies based on predefined criteria and bias assessment. Effect sizes (Hedge's g) were calculated using a random effects model with 95% confidence intervals. The study followed PRISMA guidelines and was pre-registered (PROSPERO ID: CRD42024598615).

resultsOur sample included 2,314 patients and fourteen interventions. The overall mean effect size was -0.298 (95% CI, [-0.470, -0.126]), representing a medium, statistically significant effect. Subgroup analyses revealed medium, statistically significant effects for both AVATAR therapy and cognitive behavioural therapy (CBT). Conversely, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) showed small, non-significant effects.

conclusionsAVATAR therapy has the strongest evidence for treating AVHs, highlighting the need for large-scale RCTs and integration into treatment guidelines. CBT requires methodological standardisation. Acceptance and commitment therapy shows promise but needs further high-quality RCTs. Non-invasive brain stimulation techniques require additional trials before clinical implementation.

Indexed as

Cognitive Behavioral TherapyHallucinationsOutcome Assessment, Health CareSchizophreniaTranscranial Direct Current StimulationHumansRandomized Controlled Trials as Topicauditory verbal hallucinationspsychosisschizophreniavoices

Identifiers

PMID41063577
PMCPMC12646125

What OpenQuestion holds

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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.