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Review: early intervention services can be clinically beneficial for people with early psychosis

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Question

Question: How effective are early intervention services, cognitive behavioural therapy (CBT) and family interventions for people with early psychosis?

Outcomes: Duration of untreated psychosis, hospital admissions, psychotic relapse, mean positive and negative symptoms (measurement scales: Positive and Negative Syndrome Scale, Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Brief Psychiatric Rating Scale).

Methods

Design: Systematic review and meta-analysis.

Data sources: CINAHL, CENTRAL, EMBASE, MEDLINE and PsycINFO searched from database inception to September 2009; some hand searching and backwards citation checking.

Study selection and analysis: Inclusion criteria: Patients with diagnosis of early psychosis (clinical diagnosis within 5 years of first presentation or episode). Exclusion criteria: Interventions targeted at prepsychotic or prodromal patients, or those in high-risk groups; trials that did not clearly report randomisation; trials with fewer than 10 participants. The Scottish Intercollegiate Guidelines Network checklist was used to assess eligibility. Two authors extracted study details, and three extracted outcome data. One author checked for accuracy.

Main results

Four trials (n=800) …

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