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Which psychological interventions improve quality of life in patients with schizophrenia-spectrum disorders? A meta-analysis of randomized controlled trials

Published online by Cambridge University Press:  20 October 2023

Eleni Petkari*
Affiliation:
Faculty of Health Sciences, Universidad Internacional de La Rioja (UNIR), Logroño, Spain
Elena Nikolaou
Affiliation:
Licensed Clinical Psychologist, Independent Practice, Nicosia, Cyprus
Sandra Oberleiter
Affiliation:
Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
Stefan Priebe
Affiliation:
Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
Jakob Pietschnig
Affiliation:
Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
*
Corresponding author: Eleni Petkari; Email: eleni.petkari@unir.net

Abstract

Quality of life (QoL) is a major patient reported outcome used to measure the psychological treatments success in people with schizophrenia-spectrum disorders. To date, the specific impact of different interventions on QoL remains undefined. A meta-analysis of Randomized Controlled Trials (RCTs) was carried out for this purpose. We searched Proquest, PUBMED/MEDLINE, PsycINFO, WOS, Scopus, the Cochrane Library for RCTs published until January 2023. We used multilevel meta-analysis to examine differences between intervention effectiveness of experimental and control conditions whilst accounting for data dependencies. By means of subgroup analyses, we investigated influences of intervention types (i.e. psychoeducation v. CBT v. cognitive v. combination of several types v. other, such as psychodynamic, systemic, etc.) and continuous moderators were examined with precision-weighted meta-regressions. The generalizability of results across moderators, their combinations, and analytical approaches was investigated with multiverse meta-analyses. We examined data of 60 independent studies, reporting intervention effects for objective and subjective QoL (k = 19 and 70 effect sizes based on N = 1024 and 6254 participants, respectively). Overall, psychological interventions seemed to be more effective for objective than for subjective QoL. However, specific intervention results were differentiated, suggesting largest effects of psychoeducation on objective and combined interventions on subjective QoL. Our findings suggest that QoL is a valid outcome criterion for testing intervention effectiveness, as it is sensitive to change. Additionally, psychological interventions can improve patients' QoL, though the effects are small. Further testing of less widely used interventions and a shift toward the multidimensional nature of QoL is still necessary.

Type
Review Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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