Cognitive Behavioral Therapy for Prodromal Stage of Psychosis-Outcomes for Transition, Functioning, Distress, and Quality of Life: A Systematic Review and Meta-analysis.
Schizophr Bull
; 48(1): 8-19, 2022 01 21.
Article
em En
| MEDLINE
| ID: mdl-33944949
ABSTRACT
OBJECTIVE:
This study aimed to provide insight into the efficacy of cognitive-behavioral therapy for psychosis (CBTp) in patients with "clinical high risk of psychosis (CHR-P)".METHODS:
Major scientific databases were searched up to April 17, 2020. Randomized controlled trials in CHR-P individuals, comparing CBTp with needs-based interventions (NBI, including treatment as usual or nonspecific control treatment) were included, following PRISMA guidelines. The primary outcome (efficacy) was transition to psychosis by 6 months, 12 months, 24 months, and over 24 months. Secondary outcomes were change in attenuated psychotic symptoms, depression, distress, improvements in functioning, and quality of life.RESULTS:
Ten randomized controlled studies met inclusion criteria. The comparisons included 1128 participants. CBTp was significantly more efficacious in reducing rate of transition to psychosis by 6 months (after post-hoc sensitivity analysis) (relative risk [RR] = 0.44, 95% confidence interval [CI] 0.26, 0.73), 12 months (RR = 0.44, 95% CI 0.30, 0.64), 12 months (RR = 0.46, 95%CI 0.30, 0.69), and over 24 months (RR = 0.58, 95% CI 0.35, 0.95) after treatment, compared with those receiving NBI. CBTp was also associated with more reduced attenuated psychotic symptoms by 12 months (SMD = -0.17, 95% CI -0.33, -0.02) and by 24 months (SMD = -0.24, 95% CI -0.43, -0.06). No beneficial effects on functioning, depression, quality of life, or distress were observed favoring CBTp.CONCLUSIONS:
CBTp is effective in reducing both psychosis transition rates and attenuated psychotic symptoms for the prodromal stage of psychosis. It is a promising intervention at the preventative stage.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Transtornos Psicóticos
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Qualidade de Vida
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Terapia Cognitivo-Comportamental
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Avaliação de Resultados em Cuidados de Saúde
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Progressão da Doença
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Sintomas Prodrômicos
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article