Psychological and psychosocial interventions for treatment-resistant schizophrenia: a systematic review and network meta-analysis

作者：Nurul Husna Salahuddin, Alexandra Schütz, Gabi Pitschel‐Walz, Susanna Franziska Mayer, Anna Chaimani, Spyridon Siafis, Josef Priller, Stefan Leucht, Irene Bighelli · 发表于：The Lancet Psychiatry · 年份：2024 · DOI：10.1016/s2215-0366(24)00136-6 · 被引用次数：41 · 研究领域：Schizophrenia research and treatment、Meta-analysis and systematic reviews、Treatment of Major Depression

BACKGROUND: Many patients with schizophrenia have symptoms that do not respond to antipsychotics. This condition is called treatment-resistant schizophrenia and has not received specific attention as opposed to general schizophrenia. Psychological and psychosocial interventions as an add-on treatment to pharmacotherapy could be useful, but their role and comparative efficacy to each other and to standard care in this population are not known. We investigated the efficacy, acceptability, and tolerability of psychological and psychosocial interventions for patients with treatment-resistant schizophrenia. METHODS: In this systematic review and network meta-analysis (NMA), we searched for published and unpublished randomised controlled trials (RCTs) through a systematic database search in BIOSIS, CINAHL, Embase, LILACS, MEDLINE, PsychInfo, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform for articles published from inception up to Jan 31, 2020. We also searched the Cochrane Schizophrenia Group registry for studies published from inception up to March 31, 2022, and PubMed and Cochrane CENTRAL for studies published from inception up to July 31, 2023. We included RCTs that included patients with treatment-resistant schizophrenia. The primary outcome was overall symptoms. We did random-effects pairwise meta-analyses and NMAs to calculate standardised mean differences (SMDs) or risk ratios with 95% CIs. No people with lived experience were involved throu...