A systematic review and meta-analysis of cognitive behavioural informed psychological interventions for psychiatric inpatients with psychosis

SCHIZOPHRENIA RESEARCH

卷:222

Review

Wood, Lisa^1,2  Williams, Claire¹  Billings, Jo²  Johnson, Sonia² 

[1] North East London NHS Fdn Trust, Goodmayes Hosp, Acute & Rehabil Directorate, Barley Lane, Ilford IG3 8XJ, Essex, England

[2] UCL, Div Psychiat, Maple House,149 Tottenham Court Rd, London W1T 7BN, England

关键词: CBTp;    Systematic review;    Psychiatric inpatient;    Mental health inpatient;    Cognitive behavioural therapy;    Psychosis;    Schizophrenia;   

DOI  :  10.1016/j.schres.2020.03.041

来源: Elsevier

【 摘 要 】

Psychological interventions such as Cognitive Behavioural Therapy for psychosis (CBTp) are recommended by the National Institute of Health and Care Excellence (NICE) for delivery in the acute phase of people's mental health difficulties. However, the effectiveness of cognitive behavioural informed psychological therapies for psychiatric inpatients is unknown. The aim of this review is to examine the type, quality and efficacy of cognitive behavioural informed psychological interventions for psychiatric inpatients experiencing psychosis. A systematic review and meta-analysis was conducted of randomised controlled trials examining the efficacy of cognitive behavioural informed psychological interventions offered to acute psychiatric inpatients with psychosis on primary (positive symptoms) and secondary outcomes of interest. A total of 23 studies were identified reporting on 18 trials of interventions such as CBTp, Acceptance and Commitment Therapy (ACT) and Metacognitive Therapy (MCT). Cognitive behavioural informed psychological interventions were found not be effective in reducing positive symptoms (primary outcome) at post-therapy and at follow-up but when a one study removed analysis was conducted a positive effect was found at both time points. In regard to secondary outcomes, cognitive behavioural informed psychological interventions demonstrated a significant favourable effect on negative symptoms (post-therapy), total symptoms (post-therapy and follow-up), functioning (post-therapy and follow-up) and readmission (follow-up). These psychological interventions may have potential to be effective for those admitted to psychiatric inpatient care and in acute crisis. However, findings are equivocal with evidence that these interventions have effect on some symptom measures but not others. Further examination of inpatient adapted cognitive behavioural informed psychological interventions is required. (c) 2020 Elsevier B.V. All rights reserved.

【 授权许可】

Free