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Attenuated psychotic symptom interventions in youth at risk of psychosis: A systematic review and meta-analysis

Forfatter(e)
Devoe, D. J. Farris, M. S. Townes, P. Addington, J.
År
2018
DOI
10.1111/eip.12677
Tidsskrift
Early intervention in psychiatry
Sider
11
Kategori(er)
Psykose
Tiltakstype(r)
Kognitiv atferdsterapi, atferdsterapi og kognitiv terapiAntipsykotika Kosttilskudd og ernæring
Abstract

AIM: Attenuated psychotic symptoms (APSs) have been the primary emphasis in youth at clinical high risk (CHR) for psychosis for assessing symptomology and determining subsequent transition to a psychotic disorder. Previous reviews primarily focused on the efficacy of cognitive behavioural therapy (CBT) on APS; however, a comprehensive assessment of other interventions to date is lacking. Therefore, we conducted a systematic review and meta-analysis of all intervention studies examining APS in CHR youth.

METHOD: The authors searched Embase, CINAHL, PsycINFO, Medline and EBM from inception to May 2017. Studies were selected if they included any intervention that reported follow-up APS in youth at CHR. Interventions were evaluated and stratified by time using both pairwise and network meta-analyses (NMAs). Due to the differences in APS scales, effect sizes were calculated as Hedges g and reported as the standardized mean difference (SMD).

RESULTS: Forty-one studies met our inclusion criteria. In pairwise meta-analyses, CBT was associated with a trend towards reduction in APS compared to controls at 12-months. In the NMA, integrated psychological therapy, CBT, supportive therapy, family therapy, needs-based interventions, omega-3, risperidone plus CBT and olanzapine were not significantly more effective at reducing APS at 6 and 12 months relative to any other intervention.

CONCLUSIONS: CBT demonstrated a slight trend at reducing APS at long-term follow-up compared to controls. No interventions were significantly more effective at reducing APS compared to all other interventions in the NMA.

[Correction added on 4 June 2018, after first online publication: Some parts of the Abstract section particularly 'Results' and 'Conclusions' have been corrected.].