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Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

Nowak I, Sabariego C, Świtaj P, Anczewska M - BMC Psychiatry (2016)

Bottom Line: The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive.These results indicate that CBT interventions going beyond symptom reduction are still needed.Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

View Article: PubMed Central - PubMed

Affiliation: First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957, Warsaw, Poland. inowak@ipin.edu.pl.

ABSTRACT

Background: Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains.

Methods: Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines.

Results: A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive.

Conclusions: Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions seem to be a promising treatment approach as they target disability from a broader perspective including activity and participation domains. Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of the study selection process
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Related In: Results  -  Collection

License 1 - License 2
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Fig1: Flow diagram of the study selection process

Mentions: Study selection process is presented in Fig. 1. Fifty articles were included in the review.Fig. 1


Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

Nowak I, Sabariego C, Świtaj P, Anczewska M - BMC Psychiatry (2016)

Flow diagram of the study selection process
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940955&req=5

Fig1: Flow diagram of the study selection process
Mentions: Study selection process is presented in Fig. 1. Fifty articles were included in the review.Fig. 1

Bottom Line: The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive.These results indicate that CBT interventions going beyond symptom reduction are still needed.Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

View Article: PubMed Central - PubMed

Affiliation: First Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957, Warsaw, Poland. inowak@ipin.edu.pl.

ABSTRACT

Background: Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains.

Methods: Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines.

Results: A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive.

Conclusions: Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions seem to be a promising treatment approach as they target disability from a broader perspective including activity and participation domains. Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

No MeSH data available.


Related in: MedlinePlus