Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis.
BACKGROUND:Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. METHODS:Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO,...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2015-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC4324833?pdf=render |
id |
doaj-b7aef8c6e5354fcb9b687ee574671780 |
---|---|
record_format |
Article |
spelling |
doaj-b7aef8c6e5354fcb9b687ee5746717802020-11-25T01:25:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011716610.1371/journal.pone.0117166Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis.Megan R StaffordEvan Mayo-WilsonChristina E LoucasAnthony JamesChris HollisMax BirchwoodTim KendallBACKGROUND:Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. METHODS:Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO, and CENTRAL were searched to July 2013 without restriction to publication status. Randomised trials comparing any pharmacological, psychological, or combined intervention for psychosis and schizophrenia in children, adolescents and young adults were included. Studies were assessed for bias, and GRADE criteria were used to describe the quality of the results. RESULTS:Twenty-seven trials including 3067 participants were identified. Meta-analyses were performed for 12 comparisons: symptoms, relapse, global state, psychosocial functioning, depression, weight and discontinuation. Low quality evidence demonstrated that antipsychotics have small beneficial effects on psychotic symptoms (SMD = -0.42, 95% CI -0.58 to -0.26), and a medium adverse effect on weight gain (WMD = 1.61, 95% CI 0.61 to 2.60) and discontinuation due to side effects (RR = 2.44, 95% CI, 1.12 to 5.31). There were no trials of psychological treatments in under-18 year olds. There was no evidence of an effect of psychological interventions on psychotic symptoms in an acute episode, or relapse rate, but low quality evidence of a large effect for family plus individual CBT on the number of days to relapse (WMD = 32.25, 95% CI -36.52 to -27.98). CONCLUSIONS:For children, adolescents and young adults, the balance of risk and benefit of antipsychotics appears less favourable than in adults. Research is needed to establish the potential for psychological treatments, alone and in combination with antipsychotics, in this population.http://europepmc.org/articles/PMC4324833?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Megan R Stafford Evan Mayo-Wilson Christina E Loucas Anthony James Chris Hollis Max Birchwood Tim Kendall |
spellingShingle |
Megan R Stafford Evan Mayo-Wilson Christina E Loucas Anthony James Chris Hollis Max Birchwood Tim Kendall Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. PLoS ONE |
author_facet |
Megan R Stafford Evan Mayo-Wilson Christina E Loucas Anthony James Chris Hollis Max Birchwood Tim Kendall |
author_sort |
Megan R Stafford |
title |
Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
title_short |
Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
title_full |
Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
title_fullStr |
Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
title_full_unstemmed |
Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
title_sort |
efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: a systematic review and meta-analysis. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2015-01-01 |
description |
BACKGROUND:Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. METHODS:Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO, and CENTRAL were searched to July 2013 without restriction to publication status. Randomised trials comparing any pharmacological, psychological, or combined intervention for psychosis and schizophrenia in children, adolescents and young adults were included. Studies were assessed for bias, and GRADE criteria were used to describe the quality of the results. RESULTS:Twenty-seven trials including 3067 participants were identified. Meta-analyses were performed for 12 comparisons: symptoms, relapse, global state, psychosocial functioning, depression, weight and discontinuation. Low quality evidence demonstrated that antipsychotics have small beneficial effects on psychotic symptoms (SMD = -0.42, 95% CI -0.58 to -0.26), and a medium adverse effect on weight gain (WMD = 1.61, 95% CI 0.61 to 2.60) and discontinuation due to side effects (RR = 2.44, 95% CI, 1.12 to 5.31). There were no trials of psychological treatments in under-18 year olds. There was no evidence of an effect of psychological interventions on psychotic symptoms in an acute episode, or relapse rate, but low quality evidence of a large effect for family plus individual CBT on the number of days to relapse (WMD = 32.25, 95% CI -36.52 to -27.98). CONCLUSIONS:For children, adolescents and young adults, the balance of risk and benefit of antipsychotics appears less favourable than in adults. Research is needed to establish the potential for psychological treatments, alone and in combination with antipsychotics, in this population. |
url |
http://europepmc.org/articles/PMC4324833?pdf=render |
work_keys_str_mv |
AT meganrstafford efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT evanmayowilson efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT christinaeloucas efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT anthonyjames efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT chrishollis efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT maxbirchwood efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis AT timkendall efficacyandsafetyofpharmacologicalandpsychologicalinterventionsforthetreatmentofpsychosisandschizophreniainchildrenadolescentsandyoungadultsasystematicreviewandmetaanalysis |
_version_ |
1725113580097896448 |