Table 1.
Summary of Findings
| Cognitive behavioral therapy compared with other psychosocial therapies for schizophrenia | ||||||
| Patient or population: patients with schizophreniaSettings: in either community or in hospital settingsIntervention: cognitive behavioral therapyComparison: other psychosocial therapies | ||||||
| Outcomes | Illustrative Comparative Risks a (95% CI) | Relative Effect (95% CI) | No. of Participants (Studies) | Quality of the Evidence (GRADE) | Comments | |
| Assumed Risk | Corresponding Risk | |||||
| Other Psychosocial Therapies | Cognitive Behavioral Therapy | |||||
| Adverse effect/event: 2. Adverse effects—any—medium term only Follow-up: 26–52 weeks | Low 1 | RR 2 (0.71—5.64) | 198 (1 study) | ⊕⊝⊝⊝ very low 2 , 3 , 4 , 5 | ||
| 10 per 1000 | 20 per 1000 (7–56) | |||||
| Moderate 1 | ||||||
| 50 per 1000 | 100 per 1000 (35–282) | |||||
| High 1 | ||||||
| 100 per 1000 | 200 per 1000 (71–564) | |||||
| Global state: 1. Relapse—long term Follow-up: 12 months6 | Low | RR 0.91 (0.63—1.32) | 350 (5 studies) | ⊕⊕⊝⊝low 2 , 5 | ||
| 100 per 1000 | 91 per 1000 (63–132) | |||||
| Moderate | ||||||
| 500 per 1000 | 455 per 1000 (315–660) | |||||
| High | ||||||
| 700 per 1000 | 637 per 1000 (441–924) | |||||
| Global state: 2. Rehospitalization—long term Follow-up: 12 months6 | Low 1 | RR 0.86 (0.62 to 1.21) | 294 (5 studies) | ⊕⊕⊝⊝low 2 , 5 | ||
| 100 per 1000 | 86 per 1000 (62–121) | |||||
| Moderate 1 | ||||||
| 300 per 1000 | 258 per 1000 (186–363) | |||||
| High 1 | ||||||
| 500 per 1000 | 430 per 1000 (310–605) | |||||
| Mental state: 1. General—No important or reliable change—long term Follow-up: 12 months6 | Low 1 | RR 0.84 (0.64 to 1.09) | 244 (4 studies) | ⊕⊝⊝⊝ very low 2 , 5 , 7 | ||
| 400 per 1000 | 336 per 1000 (256–436) | |||||
| Moderate 1 | ||||||
| 600 per 1000 | 504 per 1000 (384–654) | |||||
| High 1 | ||||||
| 800 per 1000 | 672 per 1000 (512–872) | |||||
| Social functioning: 1a. Average scores (Social Functioning Scale, high = good) Follow-up: median 26 weeks | The mean social functioning: 1a. average scores (social functioning scale, high = good) in the intervention groups was 8.8 higher (4.07 lower to 21.67 higher) | 65 (1 study) | ⊕⊝⊝⊝ very low 2 , 5 , 8 | No studies reported “employment” as was prestated to be of interest for the table in review protocol. | ||
| Quality of life: Average score (EuroQOL, high = good)—long term only Follow-up: 26 weeks | The mean quality of life: average score (euroqol, high = good)—long term only in the intervention groups was 1.86 lower (19.2 lower to 15.48 higher) | 37 (1 study) | ⊕⊝⊝⊝ very low 2 , 3 , 5 | |||
a The basis for the assumed risk (eg, the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
1 Medium risk: roughly equates with that of the trial control groups. 2Limitation in design—rated “serious”: studies short, randomization poorly described, blinding at outcome—single at best and untested. 3Imprecision—rated “serious”: one small study. 4Imprecision—rated “serious”: no other studies made any report of adverse effects. 5Publication bias: rated “likely”: all trials were small—searches may fail to identify other small less positive trials. 6Long term: defined as over 1 year. 7Indirectness—rated “serious”: various measures used with differing criteria. 8Indirectness—rated “serious”: scale derived data—not “employment” as stated in protocol.