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@ARTICLE{Salahuddin:270302,
      author       = {Salahuddin, Nurul Husna and Schütz, Alexandra and
                      Pitschel-Walz, Gabi and Mayer, Susanna Franziska and
                      Chaimani, Anna and Siafis, Spyridon and Priller, Josef and
                      Leucht, Stefan and Bighelli, Irene},
      title        = {{P}sychological and psychosocial interventions for
                      treatment-resistant schizophrenia: a systematic review and
                      network meta-analysis},
      journal      = {The lancet / Psychiatry},
      volume       = {11},
      number       = {7},
      issn         = {2215-0366},
      address      = {Philadelphia, Pa.},
      publisher    = {Elsevier},
      reportid     = {DZNE-2024-00774},
      pages        = {545 - 553},
      year         = {2024},
      abstract     = {Many patients with schizophrenia have symptoms that do not
                      respond to antipsychotics. This condition is called
                      treatment-resistant schizophrenia and has not received
                      specific attention as opposed to general schizophrenia.
                      Psychological and psychosocial interventions as an add-on
                      treatment to pharmacotherapy could be useful, but their role
                      and comparative efficacy to each other and to standard care
                      in this population are not known. We investigated the
                      efficacy, acceptability, and tolerability of psychological
                      and psychosocial interventions for patients with
                      treatment-resistant schizophrenia.In this systematic review
                      and network meta-analysis (NMA), we searched for published
                      and unpublished randomised controlled trials (RCTs) through
                      a systematic database search in BIOSIS, CINAHL, Embase,
                      LILACS, MEDLINE, PsychInfo, ClinicalTrials.gov, and the WHO
                      International Clinical Trials Registry Platform for articles
                      published from inception up to Jan 31, 2020. We also
                      searched the Cochrane Schizophrenia Group registry for
                      studies published from inception up to March 31, 2022, and
                      PubMed and Cochrane CENTRAL for studies published from
                      inception up to July 31, 2023. We included RCTs that
                      included patients with treatment-resistant schizophrenia.
                      The primary outcome was overall symptoms. We did
                      random-effects pairwise meta-analyses and NMAs to calculate
                      standardised mean differences (SMDs) or risk ratios with
                      $95\%$ CIs. No people with lived experience were involved
                      throughout the research process. The study protocol was
                      registered in PROSPERO, CRD42022358696.We identified 30 326
                      records, excluding 24 526 by title and abstract screening.
                      5762 full-text articles were assessed for eligibility, of
                      which 5540 were excluded for not meeting the eligibility
                      criteria, and 222 reports corresponding to 60 studies were
                      included in the qualitative synthesis. Of these, 52 RCTs
                      with 5034 participants (1654 $[33·2\%]$ females and 3325
                      $[66·8\%]$ males with sex indicated) comparing 20
                      psychological and psychosocial interventions provided data
                      for the NMA. Mean age of participants was 38·05 years
                      (range 23·10-48·50). We aimed to collect ethnicity data,
                      but they were scarcely reported. According to the quality of
                      evidence, cognitive behavioural therapy for psychosis (CBTp;
                      SMD -0·22, $95\%$ CI -0·35 to -0·09, 35 trials), virtual
                      reality intervention (SMD -0·41, -0·79 to -0·02, four
                      trials), integrated intervention (SMD -0·70, -1·18 to
                      -0·22, three trials), and music therapy (SMD -1·27, -1·83
                      to -0·70, one study) were more efficacious than standard
                      care in reducing overall symptoms. No indication of
                      publication bias was identified.We provide robust findings
                      that CBTp can reduce the overall symptoms of patients with
                      treatment-resistant schizophrenia, and therefore clinicians
                      can prioritise this intervention in their clinical practice.
                      Other psychological and psychosocial interventions showed
                      promising results but need further investigation.DAAD-ASFE.},
      keywords     = {Humans / Network Meta-Analysis / Psychosocial Intervention:
                      methods / Schizophrenia, Treatment-Resistant: therapy /
                      Randomized Controlled Trials as Topic / Psychotherapy:
                      methods / Antipsychotic Agents: therapeutic use / Treatment
                      Outcome / Schizophrenia: therapy / Antipsychotic Agents (NLM
                      Chemicals)},
      cin          = {AG Priller},
      ddc          = {610},
      cid          = {I:(DE-2719)5000007},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38879276},
      doi          = {10.1016/S2215-0366(24)00136-6},
      url          = {https://pub.dzne.de/record/270302},
}