Psychological interventions for people with psychotic experiences: protocol for a systematic review and meta-analysis

Emma Soneson; Debra Russo; Clare Knight; Louise Lafortune; Margaret Heslin; Jan Stochl; Alex Georgiadis; Julieta Galante; Robbie Duschinsky; Nick Grey; Leticia Gonzalez-Blanco; Juliet Couche; Michelle Griffiths; Hannah Murray; Nesta Reeve; Joanne Hodgekins; Paul French; David Fowler; Sarah Byford; Mary Dixon-Woods; Peter B Jones; Jesus Perez

doi:10.1186/s13643-019-1041-5

Psychological interventions for people with psychotic experiences: protocol for a systematic review and meta-analysis

Syst Rev. 2019 May 23;8(1):124. doi: 10.1186/s13643-019-1041-5.

Authors

Emma Soneson¹, Debra Russo², Clare Knight³, Louise Lafortune⁴, Margaret Heslin⁵, Jan Stochl³, Alex Georgiadis⁶, Julieta Galante³, Robbie Duschinsky⁷, Nick Grey⁸, Leticia Gonzalez-Blanco⁹, Juliet Couche¹⁰, Michelle Griffiths¹¹, Hannah Murray¹², Nesta Reeve¹³, Joanne Hodgekins¹⁴, Paul French¹⁵, David Fowler¹⁶, Sarah Byford⁵, Mary Dixon-Woods⁶, Peter B Jones³, Jesus Perez³

Affiliations

¹ Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK. es703@medschl.cam.ac.uk.
² Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK. dr335@medschl.cam.ac.uk.
³ Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK.
⁴ Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.
⁵ King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
⁶ THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, CB2 0AH, UK.
⁷ The Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK.
⁸ , Hove, UK.
⁹ Department of Psychiatry, University of Oviedo - CIBERSAM - Servicio de Salud del Principado de Asturias, Oviedo, Spain.
¹⁰ Health in Mind, Sussex Partnership NHS Foundation Trust, Woodside, The Drive, Hellingly, East Sussex, BN27 4ER, UK.
¹¹ Elizabeth House, Fulbourn Hospital, Cambridge, CB21 5EF, UK.
¹² Oxford Centre for Anxiety Disorders and Trauma, Paradise Square, Oxford, OX1 1TW, UK.
¹³ Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE, UK.
¹⁴ Department of Clinical Psychology, Elizabeth Fry Building, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
¹⁵ Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK.
¹⁶ School of Psychology, Pevensey Building, University of Sussex, Brighton, BN1 9QH, UK.

Abstract

Background: Many people who have common mental disorders, such as depression and anxiety, also have some psychotic experiences. These experiences are associated with higher clinical complexity, poor treatment response, and negative clinical outcomes. Psychological interventions have the potential to improve outcomes for people with psychotic experiences. The aims of this systematic review are to (1) synthesise the evidence on the effectiveness and cost-effectiveness of psychological interventions to reduce psychotic experiences and their associated distress and (2) identify key components of effective interventions.

Methods: Our search strategy will combine terms for (1) psychological interventions, (2) psychotic experiences, and (3) symptoms associated with psychotic experiences. We will search the following online databases: MEDLINE, Embase, PsycINFO, all Cochrane databases, British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Management Information Consortium (HMIC), Education Resources Information Center (ERIC), and EconLit. Our primary outcome is the proportion of people who recovered or remitted from psychotic experiences after the intervention. Our secondary outcomes are changes in positive psychotic symptoms, negative psychotic symptoms, depression, anxiety, functioning (including social, occupational, and academic), quality of life, and cost-effectiveness. Two independent reviewers will judge each study against pre-specified inclusion and exclusion criteria and will extract study characteristics, outcome data, and intervention components. Risk of bias and methodological quality will be assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and the Drummond Checklist. Results will be synthesised using random-effects meta-analysis and narrative synthesis.

Discussion: The identification of effective psychological interventions and of specific components associated with intervention effectiveness will augment existing evidence that can inform the development of a new, tailored intervention to improve outcomes related to psychotic symptoms, anxiety and depression, distress, functioning, and quality of life.

Systematic review registration: PROSPERO CRD42016033869.

Keywords: At-risk mental state; Cognitive behavioural therapy; Psychological intervention; Psychosis; Psychotic experiences; Therapy; Ultra-high risk.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cost-Benefit Analysis
Humans
Mental Disorders / psychology
Meta-Analysis as Topic
Psychological Techniques
Psychotic Disorders* / psychology
Psychotic Disorders* / therapy
Research Design
Stress, Psychological / therapy*
Systematic Reviews as Topic
Treatment Outcome