CBTp for people with treatment refractory schizophrenia on clozapine: a systematic review and meta-analysis.
CBTp
Treatment refractory schizophrenia
clozapine
meta-analysis
systematic review
Journal
Journal of mental health (Abingdon, England)
ISSN: 1360-0567
Titre abrégé: J Ment Health
Pays: England
ID NLM: 9212352
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
pubmed:
21
10
2020
medline:
16
3
2023
entrez:
20
10
2020
Statut:
ppublish
Résumé
Cognitive behavioural therapy for psychosis (CBTp), an effective treatment for people with schizophrenia, may have a role in clozapine refractory schizophrenia. A systematic-review and meta-analysis on the impact of CBTp on psychotic symptoms in people on clozapine. We searched PubMed, Embase, PsycInfo, CINAHL and Cochrane for randomised control trials of CBTp as augmentation in people with treatment-refractory schizophrenia on clozapine and conducted pair-wise meta-analyses. Four studies met inclusion criteria. On pairwise meta-analyses, the primary outcome of total psychotic symptoms was not significantly altered by CBTp at either therapy endpoint or six to twelve months follow-up. Secondary outcomes showed that CBT improved positive symptoms at both therapy endpoint (SMD -0.33, 95%CI -0.50 to -0.16, CBTp may lead to small benefits for positive symptoms refractory to clozapine. Given the low risks associated with CBTp, and the limited alternative options for clozapine refractory schizophrenia, this approach should be considered in this population.
Sections du résumé
BACKGROUND
UNASSIGNED
Cognitive behavioural therapy for psychosis (CBTp), an effective treatment for people with schizophrenia, may have a role in clozapine refractory schizophrenia.
AIMS
UNASSIGNED
A systematic-review and meta-analysis on the impact of CBTp on psychotic symptoms in people on clozapine.
METHODS
UNASSIGNED
We searched PubMed, Embase, PsycInfo, CINAHL and Cochrane for randomised control trials of CBTp as augmentation in people with treatment-refractory schizophrenia on clozapine and conducted pair-wise meta-analyses.
RESULTS
UNASSIGNED
Four studies met inclusion criteria. On pairwise meta-analyses, the primary outcome of total psychotic symptoms was not significantly altered by CBTp at either therapy endpoint or six to twelve months follow-up. Secondary outcomes showed that CBT improved positive symptoms at both therapy endpoint (SMD -0.33, 95%CI -0.50 to -0.16,
CONCLUSIONS
UNASSIGNED
CBTp may lead to small benefits for positive symptoms refractory to clozapine. Given the low risks associated with CBTp, and the limited alternative options for clozapine refractory schizophrenia, this approach should be considered in this population.
Identifiants
pubmed: 33076721
doi: 10.1080/09638237.2020.1836558
doi:
Substances chimiques
Clozapine
J60AR2IKIC
Antipsychotic Agents
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM