Summary of results from systematic reviews of specific non-pharmacological treatments
| Outcomes | ||||
|---|---|---|---|---|
| Broad class of intervention | Experimental group | Control group | Short term 0–6 months | Medium term >6–24 months |
| RR = relative risk (experimental event rate/control event rate); CI = 95% confidence intervals (an estimate of the precision of RR); ↓ = decreased; ↑ = increased; ― = no clear difference; MD = mean difference; CBT = cognitive behavioural therapy. | ||||
| Supportive educational interventions | Individual psychoeducational8 (n=428) | Standard care (n=360) | Relapse ↓ (RR=0.8; CI 0.7 to 0.92) | |
| Attrition ― (RR=1.13; CI 0.89 to 1.44) | ||||
| Family intervention9 (n=387) | Standard care (n=358) | Relapse ― (RR=0.6; CI 0.3 to 1.2) | Relapse ↓ (RR=0.7; CI 0.5 to 0.99) | |
| Attrition ― (RR=0.99; CI 0.72 to 1.4) | ||||
| Drug compliance ― (RR=0.8; CI 0.6 to 1.0) | ||||
| Unemployed ― (RR=1.1; CI 0.9 to 1.3) | ||||
| Living independently ― | ||||
| Family burden ↓ (MD=−0.4; CI −0.7 to −0.1) | ||||
| Skills training | Life skills11 (n=20) | Standard care (n=18) | Attrition ― (RR=2.0; CI 0.2 to 20) | |
| Social skills12 (n=88) | Standard care (n=79) | Relapse ― (RR=0.88; CI 0.6 to 1.3) | ||
| Poor compliance with therapy ― (RR=1.1; CI 0.6 to 2) | ||||
| (n=43) | Supportive group psychotherapy (n=37) | Relapse ― (RR=0.94; CI 0.6 to 1.4) | ||
| Poor compliance with therapy ― (RR=1.2; CI 0.6 to 2.4) | ||||
| Problem/symptom focused therapies | CBT15 (n=148) | Standard care (n=140) | Admitted ― (RR=0.36; CI 0.1 to 1.04) | Admitted ↓ (RR=0.66; CI 0.5 to 0.9) |
| Mental state unimproved ↓ (RR=0.24; CI 0.1 to 0.5) | Mental state unimproved ↓ (RR=0.81; CI 0.7 to 0.99) | |||
| Attrition ― (RR=0.79; CI 0.4 to 1.5) | Attrition ― (RR=0.80; CI 0.5 to 1.2) | |||
| Supportive counselling (n=26) | Relapse ― (RR=0.63; CI 0.2 to 2.1) | |||
| (n=33) | Mental state unimproved ― (RR=0.79; CI 0.6 to 1.05) | |||
| Attrition ― (RR=3.1; CI 0.4 to 26.5) | ||||
| Cognitive rehabilitation19 (n=42) | Standard care (n=42) | Mental state: average BPRS end score ― (MD −0.9; CI −2.9 to 1.1) | ||
| Attrition ― (RR=1.0; CI 0.22 to 4.6) | ||||
| (n=17) | Occupational therapy (n=16) | Mental state: average BPRS end score ― (MD −2.5; CI −11 to 5.6) | ||
| Attrition ― (RR=2.8; CI 0.33 to 24) | ||||
| Psychodynamic/analytic therapy21 (n=46) | Medication (n=48) | Remaining in hospital ↑ (RR=8.0; CI 2 to 34) | ||
| Reality-adaptive psychotherapy | Attrition ↓ (RR=0.46; CI 0.3 to 0.6) | Admitted ― (RR=1.2; CI 0.9 to 1.6) Attrition ↓ (RR=0.45; CI 0.3 to 0.7) | ||
| (n=88) | (n=76) | |||
| Token economy22 (n=54) | Standard care (n=56) | Mental state (negative symptoms) ↓ (MD=−13; CI −21 to −3) | Attrition ― (RR=1.2; CI 0.4 to 3.3) | |
| Attrition ― (RR=1.2; CI 0.4 to 3.6) | ||||