Summary of findings 1. Paradoxical intention therapy compared with diazepam.
| Paradoxical intention therapy compared with diazepam for conversion disorder | ||||||
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Patient or population: people with conversion disorder according to DSM‐IV or ICD‐10 criteria Settings: outpatient and inpatient Intervention: paradoxical intention therapy Comparison: diazepam over 45 days | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Diazepam | Paradoxical intention therapy | |||||
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Reduction in physical signs (number of patients without any conversive attacks in last 2 weeks) End of treatment |
Study population | RR 1.44 (0.91 to 2.28) | 30 (1 study) | ⊕⊝⊝⊝ Very lowa,b | Paradoxical intention therapy may have no effect on physical signs at end of treatment. | |
| 600 per 1000 | 864 per 1000 (54 less to 768 more) | |||||
| Level of functioning | — | — | — | — | — | No studies assessed this outcome. |
| Quality of life | — | — | — | — | — | No studies assessed this outcome. |
| Adverse events | — | — | — | — | — | No studies assessed this outcome. |
| *The basis for the assumed risk (e.g. 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; DSM‐IV:Diagnostic and Statistical Manual of Mental Disorders 4th Edition; ICD‐10:International Classification of Diseases, Tenth Revision; 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. | ||||||
aDowngraded two levels due to imprecision (wide confidence intervals; based on one study with few patients). bDowngraded one level due to high risk of bias.