Table 3.
N | G | 95% CI | Z | P of Z | Q-value | I 2 (%) | I 2 95% CI | |
---|---|---|---|---|---|---|---|---|
SST for all symptom measures pooled | ||||||||
Vs any comparator | ||||||||
All eligible studies | 25 | 0.097 | −0.074, 0.267 | 1.112 | .266 | 53.99* | 55.48 | 30–72 |
Excluding risk of bias score of 4 | 21 | 0.090 | −0.091, 0.270 | 0.973 | .331 | 46.13* | 56.64 | 29–73 |
Excluding risk of bias score ≥3 | 13 | 0.106 | −0.131, 0.343 | 0.879 | .379 | 34.59* | 65.30 | 37–81 |
Excluding risk of bias score ≥2 | 7 | 0.173** | −0.026, 0.373 | 1.704 | .088 | 6.42 | 6.49 | 0–73 |
Vs active controls | ||||||||
All eligible studies | 18 | 0.067 | −0.151, 0.286 | 0.605 | .545 | 45.23* | 62.42 | 37–77 |
Excluding risk of bias score of 4 | 15 | 0.051 | −0.118, 0.281 | 0.440 | .660 | 37.30* | 62.47 | 34–79 |
Excluding risk of bias score ≥3 | 10 | 0.088 | −0.209, 0.385 | 0.581 | .561 | 32.38* | 72.20 | 47–85 |
Excluding risk of bias score ≥2 | 6 | 0.165 | −0.061, 0.392 | 1.431 | .152 | 6.19 | 19.15 | 0–64 |
Vs TAU | ||||||||
All eligible studies | 6 | 0.282* | 0.049, 0.515 | 2.373 | .018 | 2.80 | 0.00 | 0–75 |
Excluding risk of bias score of 4 | 5 | 0.300* | 0.054, 0.546 | 2.386 | .017 | 2.61 | 0.00 | 0–79 |
Vs SC only | ||||||||
All eligible studies | 7 | −0.104 | −0.456, 0.247 | −0.58 | .560 | 18.88* | 68.23 | 30–86 |
Excluding risk of bias score of 4 | 6 | −0.090 | −0.499, 0.318 | −0.432 | .666 | 18.81* | 73.42 | 39–88 |
Excluding risk of bias score ≥3 | 4 | −0.086 | −0.669, 0.488 | −0.294 | .769 | 17.99* | 83.32 | 58–93 |
SST for positive symptoms | ||||||||
Vs any comparator | ||||||||
All eligible studies | 13 | 0.0895 | −0.117, 0.296 | 0.85 | .397 | 23.88* | 49.8 | 5–73 |
Excluding risk of bias score of 4 | 12 | 0.984 | −0.122, 0.318 | 0.88 | .381 | 23.72* | 53.6 | 11–76 |
Excluding risk of bias score ≥3 | 9 | 0.980 | −0.150, 0.350 | 0.78 | .438 | 18.36* | 56.4 | 8–79 |
Excluding risk of bias score ≥2 | 5 | 0.050 | −0.362, 0.460, | 0.23 | .819 | 14.70* | 72.8 | 32–89 |
Vs active controls | ||||||||
All eligible studies/ excluding risk of bias 4 | 8 | 0.080 | −0.223, 0.380, | 0.50 | .620 | 19.80* | 64.6 | 25–83 |
Excluding risk of bias score ≥3 | 7 | 0.127 | −0.194, 0.450, | 0.78 | .437 | 18.04* | 66.7 | 26–85 |
Excluding risk of bias score ≥2 | 5 | 0.050 | −0.362, 0.460, | 0.23 | .819 | 14.70* | 72.8 | 32–89 |
Vs TAU | ||||||||
All eligible studies | 5 | 0.151 | −0.098, 0.400, | 1.19 | .235 | 3.68 | 0.00 | 0–79 |
Excluding risk of bias score of 4 | 4 | 0.176 | −0.110, 0.460, | 1.22 | .222 | 3.31 | 9.30 | 0–86 |
SST for negative symptoms | ||||||||
Vs any comparator | ||||||||
All eligible studies | 17 | 0.191* | 0.043, 0.338 | 2.53 | .011 | 19.67 | 18.65 | 0–54 |
Excluding risk of bias score of 4 | 15 | 0.218* | 0.077, 0.359 | 3.03 | .002 | 14.66 | 4.48 | 0–56 |
Excluding risk of bias score ≥3 | 11 | 0.194* | 0.041, 0.346 | 2.49 | .013 | 7.96 | 0.00 | 0–60 |
Excluding risk of bias score ≥2 | 7 | 0.279* | 0.087, 0.471 | 2.85 | .004 | 5.07 | 0.00 | 0–71 |
Vs active controls | ||||||||
All eligible studies | 11 | 0.136 | −0.070, 0.341 | 1.29 | .196 | 16.01 | 37.52 | 0–69 |
Excluding risk of bias score of 4 | 10 | 0.185** | −0.009, 0.378 | 1.87 | .061 | 11.94 | 24.61 | 0–64 |
Excluding risk of bias score ≥3 | 8 | 0.196* | 0.010, 0.383 | 2.07 | .039 | 0.74 | 9.54 | 0–68 |
Excluding risk of bias score ≥2 | 6 | 0.276* | 0.073, 0.478 | 2.67 | .008 | 5.05 | 1.04 | 0–75 |
Vs TAU | ||||||||
All eligible studies | 6 | 0.311* | 0.078, 0.544 | 2.61 | .009 | 2.17 | 0.00 | 0–75 |
Excluding risk of bias score of 4 | 5 | 0.300* | 0.054, 0.546 | 2.39 | .017 | 2.09 | 0.00 | 0–79 |
Vs SC only | ||||||||
All eligible studies | 4 | 0.013 | −0.283, 0.257 | 0.09 | .927 | 2.77 | 0.00 | 0–85 |
SST for PANSS general symptoms | ||||||||
Vs any comparator, all eligible studies | 6 | 0.318* | 0.043, 0.594 | 2.26 | .023 | 7.33 | 31.70 | 0–72 |
Vs TAU, all eligible studies | 4 | 0.404* | 0.111, 0.697 | 2.70 | .007 | 2.31 | 0.00 | 0–85 |
SST for social competency outcome measures | ||||||||
Vs any comparator | ||||||||
All eligible studies | 17 | 0.326* | 0.079, 0.572 | 2.59 | .010 | 49.60* | 67.79 | 47–81 |
Excluding risk of bias score of 4 | 13 | 0.364* | 0.100, 0.628 | 2.70 | .007 | 37.27* | 67.80 | 43–82 |
Excluding risk of bias score ≥3 | 9 | 0.372* | 0.036, 0.709 | 2.17 | .030 | 33.20* | 75.91 | 54–87 |
Excluding risk of bias score ≥2 | 5 | 0.193 | −0.065, 0.451 | 1.47 | .143 | 5.44 | 26.48 | 0–72 |
Vs active controls | ||||||||
All eligible studies | 12 | 0.131 | 0.234, 0496 | 0.70 | .482 | 59.59* | 81.53 | 69–89 |
Excluding risk of bias score of 4 | 10 | 0.227 | −0.170, 0.624 | 1.12 | .262 | 51.16* | 82.41 | 69–90 |
Excluding risk of bias score ≥3 | 8 | 0.320 | −0.098, 0.738 | 1.50 | .134 | 39.98 | 82.49 | 67–91 |
Excluding risk of bias score ≥2 | 5 | 0.020 | −0.312, 0.353 | 0.12 | .906 | 8.86 | 54.88 | 0–83 |
Vs TAU | ||||||||
All eligible studies | 5 | 0.201 | −0.140, 0.541 | 1.16 | .248 | 5.31 | 24.69 | 0–70 |
SST subtypes vs any comparator | ||||||||
All symptom measures pooled | ||||||||
Generic SST, all eligible studies | 7 | 0.171 | −0.127, 0.468 | 1.13 | .260 | 8.70 | 31.77 | 0–71 |
Generic SST, excl. risk of bias ≥4 | 4 | 0.364** | −0.011, 0.739 | 1.90 | .057 | 4.21 | 28.71 | 0–74 |
Cognitive-behavioral SST, excl. risk of bias ≥3 | 4 | 0.147 | −0.108, 0.403 | 1.13 | .258 | 0.59 | 0.00 | 0–85 |
Social-cognitive SST, excl. risk of bias ≥4 | 6 | 0.270 | −0.027, 0.567 | 1.78 | .075 | 6.40 | 21.92 | 0–66 |
Social-cognitive SST, excl. risk of bias ≥3 | 5 | 0.392* | 0.107, 0.678 | 2.70 | .007 | 2.48 | 0.00 | 0–79 |
Social-cognitive SST, excl. risk of bias ≥2 | 4 | 0.413* | 0.116, 0.709 | 2.73 | .006 | 2.24 | 0.00 | 0–85 |
UCLA-FAST, all eligible studies | 8 | −0.058 | −0.392, 0.276 | −0.34 | .733 | 25.19* | 72.21 | 43–86 |
UCLA-FAST, risk of bias ≥4 | 7 | −0.176 | −0.461, 0.109 | −1.21 | .226 | 15.71* | 61.81 | 13–83 |
UCLA-FAST, excl. risk of bias ≥3 | 4 | −0.201 | −0.649, 0.246 | −0.88 | .378 | 14.65 | 79.52 | 46–92 |
Negative symptoms | ||||||||
Generic SST, all eligible studies | 5 | 0.268 | −0.143, 0.678 | 1.28 | .201 | 8.66 | 53.83 | 0–83 |
Cognitive-behavioral SST, all eligible studies | 4 | 0.146 | −0.117, 0.402 | 1.11 | .266 | 0.46 | 0.00 | 0–85 |
Social-cognitive SST, all eligible studies | 5 | 0.148 | −0.213, 0.509 | 0.80 | .421 | 6.47 | 38.14 | 0–77 |
Social competency outcome measures | ||||||||
Generic SST, all eligible studies | 4 | −0.031 | −0.318, 0.256 | 0.21 | .832 | 1.31 | 0.00 | 0–85 |
Social-cognitive SST, all eligible studies | 7 | 0.301 | −0.211, 0.812 | 1.15 | .249 | 23.41* | 74.37 | 45–88 |
Social-cognitive SST, excl. risk of bias ≥4 | 6 | 0.188 | −0.340, 0.716 | 0.70 | .485 | 19.86* | 74.82 | 43–89 |
Social-cognitive SST, excl. risk of bias ≥3 | 4 | 0.478** | −0.018, 0.975 | 1.89 | .059 | 8.38* | 64.18 | 0–88 |
UCLA-FAST, all eligible studies | 5 | 0.080 | −0.587, 0.747 | 0.24 | .814 | 36.19* | 88.95 | 77–95 |
UCLA-FAST, excl. risk of bias ≥4 | 4 | 0.267 | −0.432, 0.966 | 0.75 | .454 | 27.9* | 89.25 | 75–95 |
SST vs any comparator at 6 mo follow-up | ||||||||
All symptoms, all eligible studies | 8 | 0.035 | −0.150, 0.220 | 0.37 | .712 | 1.94 | 0.00 | 0–68 |
All symptoms, excl. risk of bias ≥3 | 6 | 0.061 | −0.139, 0.260 | 0.60 | .550 | 0.97 | 0.00 | 0–75 |
All symptoms, excl. risk of bias ≥2 | 4 | 0.116 | −0.119, 0.352 | 0.97 | .333 | 0.09 | 0.00 | 0–85 |
Positive symptoms, all eligible studies | 5 | −0.084 | −0.315, 0.147 | −0.71 | .475 | 1.09 | 0.00 | 0–79 |
Positive symptoms, risk of bias ≥3 | 4 | −0.078 | −0.323, 0.166 | −0.63 | .530 | 1.06 | 0.00 | 0–85 |
Negative symptoms, all eligible studies | 7 | 0.001 | −0.207, 0.209 | 0.03 | .995 | 4.22 | 0.00 | 0–71 |
Negative symptoms, excl. risk of bias ≥3 | 5 | 0.006 | −0.223, 0.235 | 0.051 | .958 | 2.28 | 0.00 | 0–79 |
Social competency outcomes, all eligible studies | 4 | 0.096 | −0.186, 0.379 | 0.67 | .503 | 0.62 | 0.00 | 0–85 |
SST vs any comparator; longest follow-up pooled | ||||||||
All symptoms, all eligible studies | 11 | 0.209* | 0.043, 0.375 | 2.46 | .014 | 7.65 | 0.00 | 0–60 |
All symptoms, excl. risk of bias ≥4 | 9 | 0.252* | 0.075, 0.428 | 2.79 | .005 | 5.17 | 0.00 | 0–65 |
All symptoms, excl. risk of bias ≥3 | 8 | 0.237* | 0.056, 0.417 | 2.57 | .010 | 4.54 | 0.00 | 0–68 |
All symptoms, excl. risk of bias ≥2 | 5 | 0.348 | 0.122, 0.574 | 3.02 | .003 | 1.89 | 0.00 | 0–79 |
Positive symptoms, all eligible studies | 8 | 0.130 | −0.152, 0.412 | 0.91 | .366 | 16.34* | 57.15 | 6–80 |
Positive symptoms, risk of bias ≥3 | 7 | 0.156 | −0.150, 0.462 | 0.10 | .318 | 15.66* | 61.67 | 13–83 |
Positive symptoms, risk of bias ≥2 | 4 | 0.282 | −0.196, 0.760 | 1.16 | .247 | 11.57* | 74.08 | 28–91 |
Negative symptoms, all eligible studies | 10 | 0.228* | 0.025, 0.430 | 2.20 | .028 | 12.51 | 28.70 | 0–65 |
Negative symptoms, excl. risk of bias ≥3 | 8 | 0.267* | 0.055, 0.478 | 2.47 | .013 | 9.42 | 25.70 | 0–66 |
Negative symptoms, excl. risk of bias ≥2 | 5 | 0.394* | 0.148, 0.640 | 3.15 | .002 | 4.66 | 14.19 | 0–82 |
Social competency outcomes, all eligible studies | 8 | −0.100 | −0.964, 0.765 | −0.23 | .821 | 112.22* | 93.76 | 90–96 |
Social competency outcomes, excl. bias ≥4 | 6 | −0.221 | −1.356, 0.914 | −0.38 | .703 | 111.59* | 95.52 | 93–97 |
Social competency outcomes, excl. bias ≥3 | 5 | −0.331 | −1.641, 0.978 | 0.50 | .620 | 111.08* | 96.40 | 94–98 |
Social competency outcomes, excl. bias ≥2 | 4 | −0.425 | −2.165, 1.314 | 0.48 | .632 | 111.08* | 97.30 | 95–98 |
SST vs any comparator; all follow-up combined | ||||||||
All symptoms, all eligible studies | 11 | 0.141** | −0.013, 0.294 | 1.79 | .073 | 3.66 | 0.00 | 0–60 |
All symptoms, excl. risk of bias ≥4 | 10 | 0.169* | 0.007, 0331 | 2.05 | .041 | 1.93 | 0.00 | 0–62 |
All symptoms, excl. risk of bias ≥3 | 9 | 0.161** | −0.004, 0.326 | 1.91 | .057 | 1.71 | 0.00 | 0–65 |
All symptoms, excl. risk of bias ≥2 | 6 | 0.231* | 0.033, 0.429 | 2.29 | .022 | 0.09 | 0.00 | 0–75 |
Positive symptoms, all eligible studies | 8 | 0.045 | −0.158, 0.247 | 0.43 | .664 | 8.51 | 17.76 | 0–61 |
Positive symptoms, risk of bias ≥4 | 7 | 0.058 | −0.165, 0.280 | 0.51 | .612 | 8.24 | 27.17 | 0–68 |
Positive symptoms, risk of bias ≥2 | 4 | 0.130 | −0.225, 0.484 | 0.72 | .474 | 6.31 | 52.47 | 0–84 |
Negative symptoms, all eligible studies | 10 | 0.175** | −0.025, 0.374 | 1.72 | .086 | 12.02 | 25.12 | 0–64 |
Negative symptoms, excl. risk of bias ≥4 | 8 | 0.204** | −0.009, 0.416 | 1.88 | .060 | 9.40 | 25.55 | 0–66 |
Negative symptoms, excl. risk of bias ≥2 | 5 | 0.310* | 0.052, 0.567 | 2.36 | .018 | 5.02 | 20.35 | 0–66 |
Social competency outcomes, all eligible studies | 7 | −0.224 | −1.127, 0.679 | 0.47 | .627 | 91.63* | 93.45 | 89–96 |
Social competency outcomes, excl. bias ≥4 | 5 | −0.418 | −1.659, 0.823 | −0.66 | .509 | 89.64* | 95.54 | 92–97 |
Social competency outcomes, excl. bias ≥2 | 4 | −0.608 | −2.107, 0.891 | −0.80 | .427 | 87.94* | 96.59 | 94–98 |
Note: All comparisons were using random model. Risk of bias and subgroup analyses were only included in instances where at least four studies were available for that comparison. *P < .05. **P < .1. PANSS, Positive and Negative Syndromes Scale; CI, confidence Interval; SC, supportive counseling; UCLA-FAST, University of California Los Angeles-Functional Adaptive Skills Training.