Summary of findings 10. Cognitive behavioural therapy plus adjunctive physical activity compared with cognitive behavioural therapy alone.
| CBT + APA compared with CBT alone for conversion disorder | ||||||
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Patient or population: people with conversion disorder according to DSM‐IV or ICD‐10 criteria Settings: outpatients Intervention: CBT + APA Comparison: CBT | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| CBT | CBT + APA | |||||
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Reduction in physical signs (overall physical impact) As measured by PMDRS, total score (lower is better) Range: 0–128 End of treatment |
The mean reduction in physical signs in the control group was 33.2 |
MD 5.60 higher (15.48 lower to 26.68 higher) |
— | 21 (1 study) | ⊕⊝⊝⊝ Very lowa,b | CBT + APA may have no effect on physical signs at end of treatment. |
| 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). APA: adjunctive physical activity; 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; MD: mean difference; PMDRS: Psychogenic Movement Disorders Rating 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 level due to imprecision (wide confidence interval, based on one study with few participants).