Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis
Network meta-analysis (72 studies, n=10,364) found family interventions, relapse prevention programmes, CBT, family psychoeducation, integrated interventions & patient psychoeducation reduced relapse more than usual treatment at 1 year (moderate-very low confidence in estimates).
Source:
The Lancet Psychiatry
SPS commentary:
A related commentary notes that from a methodological standpoint, the report is an outstanding example of good practices. Limitations in the evidence base were meticulously counteracted. For example, the authors engaged in a far-reaching attempt to retrieve unpublished or missing data by repeatedly contacting authors of all potentially eligible studies published after 1990, thereby recovering unpublished data for nine trials. Unfortunately, owing to the fragmentation of the evidence base, for several outcomes the networks were thinly connected, with evidence of inconsistency. Consequently, this approach could not elucidate whether some interventions were superior to others.
In terms of the treatments with positive effects, choice among them could be oriented by cost-effectiveness analyses (as done for antipsychotics) or by patient preference. Concomitantly, component network meta-analysis could be employed in future research to determine which subtypes and particularly which components of these interventions are most effective.