Summary of findings 8. Specialised cognitive behavioural therapy‐based physiotherapy intervention compared with treatment as usual.
| Specialised CBT‐based physiotherapy‐led intervention compared with TAU for conversion disorder | ||||||
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Patient or population: people with conversion disorder according to DSM‐IV or ICD‐10 criteria Settings: outpatients at day hospital Intervention: specialised CBT‐based physiotherapy‐led intervention Comparison: TAU | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| TAU | Specialised CBT‐based physiotherapy‐led intervention | |||||
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Reduction in physical signs End of treatment |
— | — | — | — | — | No studies assessed this outcome at end of treatment. |
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Level of functioning As assessed by WSAS scale (lower is better) Range: 0–40 End of treatment |
The mean level of functioning in the control group was 26.9 |
MD 7.10 lower (11.40 lower to 2.80 lower) |
— | 54 (1 study) | ⊕⊝⊝⊝ Very lowa,b | Specialised CBT‐based physiotherapy intervention may slightly improve level of functioning at end of treatment. |
| 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). CBT: cognitive behavioural therapy; CI: confidence interval; DSM‐IV:Diagnostic and Statistical Manual of Mental Disorders 4th Edition; ICD‐10:International Classification of Diseases, Tenth Revision; TAU: treatment as usual; WSAS: Work and Social Adjustment Scale. | ||||||
| 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 one level due to high risk of bias. bDowngraded two levels due to imprecision (wide confidence interval and based on one study with few patients).