Pike Blue, Ambrosio Leire, Ellett Lyn
Recovery Service, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Isle of Wight, UK.
School of Health and Life Sciences, University of Southampton, Southampton, UK.
Psychol Med. 2025 May 13;55:e146. doi: 10.1017/S0033291725001126.
Although cognitive behavioral therapy for people diagnosed with schizophrenia (CBTp) is recommended in clinical guidelines internationally, rates of implementation are low. One consequence of this has been the development of brief individual psychological interventions, which are shorter than the recommended minimum of 16 sessions for CBTp. This article is the first to systematically identify the brief interventions that exist for people diagnosed with schizophrenia and to determine their effectiveness using meta-analysis.
Five electronic databases (PsycINFO, MEDLINE, CINAHL, EMBASE, and Web of Science) were searched for peer-reviewed randomized controlled trials or experimental studies of brief individual psychological interventions delivered in community settings. Random effects meta-analysis was used to integrate effect sizes, due to the heterogeneity of included studies.
Fourteen studies were identified (n = 1,382) that measured thirty clinical outcomes and included six intervention types - brief CBT, memory training, digital motivation support, reasoning training, psychoeducation, and virtual reality. Collectively, brief psychological interventions were found to be effective for psychotic symptoms (SMD -0.285, p < 0.01), paranoia (SMD -0.277, p < 0.05), data gathering (SMD 0.38, p < 0.01), depression (SMD -0.906, p < 0.05) and wellbeing (SMD 0.405, p < 0.01). For intervention types, brief CBT was effective for psychotic symptoms (SMD -0.32, p < .001), and reasoning training was effective for data gathering (SMD 0.38, p < 0.01).
Overall, the evidence suggests that brief psychological interventions are effective for several key difficulties associated with schizophrenia, providing an opportunity to improve both access to, and choice of, treatment for individuals diagnosed with schizophrenia.
尽管国际临床指南推荐对精神分裂症患者采用认知行为疗法（CBTp），但其实施率较低。由此产生的一个后果是出现了简短的个体心理干预措施，这些干预措施比CBTp推荐的最少16次疗程还要短。本文首次系统地识别了针对精神分裂症患者的简短干预措施，并通过荟萃分析确定其有效性。
检索了五个电子数据库（PsycINFO、MEDLINE、CINAHL、EMBASE和Web of Science），以查找在社区环境中实施的简短个体心理干预措施的同行评审随机对照试验或实验研究。由于纳入研究的异质性，采用随机效应荟萃分析来整合效应量。
共识别出14项研究（n = 1382），这些研究测量了30项临床结果，包括六种干预类型——简短CBT、记忆训练、数字动机支持、推理训练、心理教育和虚拟现实。总体而言，发现简短心理干预对精神病症状（标准化均数差 -0.285，p < 0.01）、偏执（标准化均数差 -0.277，p < 0.05）、数据收集（标准化均数差0.38，p < 0.01）、抑郁（标准化均数差 -0.906，p < 0.05）和幸福感（标准化均数差0.405，p < 0.01）有效。对于干预类型，简短CBT对精神病症状有效（标准化均数差 -0.32，p <.001），推理训练对数据收集有效（标准化均数差0.38，p < 0.01）。
总体而言，证据表明简短心理干预对与精神分裂症相关的几个关键难题有效，为改善精神分裂症患者的治疗可及性和治疗选择提供了机会。
