Clinical decision-making about psychological interventions is best supported by robust evidence and informed patient choice. Randomised controlled trials (RCTs) are the current gold standard in evaluating intervention effectiveness and identifying harm. At present, RCTs of psychological intervention are unlikely to include measurement of adverse effects and this is in part due to lack of consensus about this topic. A Delphi study was conducted with a panel of both professionals and people with personal experience of face-to-face psychotherapy across the spectrum of mental health difficulties to seek consensus on what to include on a measure of adverse effects. Fifty-four items derived from an initial list of 147 items generated by the panel, are included on the APTMOS outcome measure, which now in it's preliminary form now requires validation before use in RCTs. To date, the evidence for psychological interventions for psychosis and schizophrenia has not been synthesised, which is important to inform patient choice and decision-making. Network meta-analysis compares multiple interventions using direct evidence from randomised controlled trials (RCTs) and indirect evidence from the network. A systematic review of the literature identified 91 RCTs across 23 different intervention/control group categories. Psychological interventions were more effective at reducing total symptoms of psychosis than control groups. One intervention with a low risk of bias, mindfulness-based psychoeducation, was consistently identified as most effective, with large effect sizes. Subgroup analyses identified differential effectiveness in different settings and for different subgroups. Further high quality RCT evidence of the highest ranked interventions is required to inform updates to clinical guidelines of psychological interventions for psychosis.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:763975 |
| Date | January 2018 |
| Creators | McGlanaghy, Edel |
| Contributors | Morris, Paul |
| Publisher | University of Edinburgh |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/1842/33157 |
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