Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum rechts der Isar der Technischen Universitat Munchen, Munchen, Germany
Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Sicilia, Italy.
BMJ Open. 2020 Jan 19;10(1):e035073. doi: 10.1136/bmjopen-2019-035073.
There is evidence that different psychosocial interventions could reduce the risk of relapse in schizophrenia, but a comprehensive evidence based on their relative efficacy is lacking. We will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomised controlled trials (RCTs) to rank psychosocial treatments for relapse prevention in schizophrenia according to their efficacy, acceptability and tolerability.
We will include all RCTs comparing a psychosocial treatment aimed at preventing relapse in patients with schizophrenia with another psychosocial intervention or with a no treatment condition (waiting list, treatment as usual). We will include studies on adult patients with schizophrenia, excluding specific subpopulations (eg, acutely ill patients). Primary outcome will be the number of patients experiencing a relapse. Secondary outcomes will be acceptability (dropout), change in overall, positive, negative and depressive symptoms, quality of life, adherence, functioning and adverse events. Published and unpublished studies will be sought through database searches, trial registries and websites. Study selection and data extraction will be conducted by at least two independent reviewers. We will conduct random-effects NMA to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. NMA will be conducted in R within a frequentist framework. The risk of bias in studies will be evaluated using the Cochrane Risk of Bias tool and the credibility of the evidence will be evaluated using Confidence in Network Meta-Analysis (CINeMA). Subgroup and sensitivity analyses will be conducted to assess the robustness of the findings.
No ethical issues are foreseen. Results from this study will be published in peer-reviewed journals and presented at relevant conferences.
CRD42019147884.
有证据表明，不同的心理社会干预措施可以降低精神分裂症复发的风险，但缺乏基于其相对疗效的综合证据。我们将进行网络荟萃分析（NMA），整合来自随机对照试验（RCT）的直接和间接比较，根据疗效、可接受性和耐受性对预防精神分裂症复发的心理社会治疗进行排名。
我们将纳入所有比较心理社会治疗以预防精神分裂症患者复发的 RCT，与另一种心理社会干预或无治疗（等待名单、常规治疗）的 RCT 进行比较。我们将纳入成年精神分裂症患者的研究，不包括特定亚组（例如，急性病患者）。主要结局将是经历复发的患者人数。次要结局将是可接受性（辍学）、总体、阳性、阴性和抑郁症状的变化、生活质量、依从性、功能和不良事件。将通过数据库搜索、试验登记处和网站搜索发表和未发表的研究。研究选择和数据提取将由至少两名独立审查员进行。我们将进行随机效应 NMA 来综合每个结局的所有证据，并对所有治疗方法进行全面排名。NMA 将在 R 中基于频率主义框架进行。使用 Cochrane 偏倚风险工具评估研究中的偏倚风险，并使用置信网络荟萃分析（CINeMA）评估证据的可信度。将进行亚组和敏感性分析，以评估结果的稳健性。
预计不会出现伦理问题。本研究的结果将发表在同行评议的期刊上，并在相关会议上展示。
PROSPERO 注册号：CRD42019147884。
