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@ARTICLE{Salahuddin:285818,
      author       = {Salahuddin, Nurul Husna and Herlitzius, Emilia and Schütz,
                      Alexandra and Siafis, Spyridon and Priller, Josef and
                      Leucht, Stefan and Bighelli, Irene},
      title        = {{P}sychological and {P}sychosocial {I}nterventions for
                      {P}eople {W}ith {S}chizophrenia and {C}o-{O}ccurring
                      {S}ubstance {U}se {D}isorders: {A} {S}ystematic {R}eview and
                      {M}eta-{A}nalysis.},
      journal      = {JAMA psychiatry},
      volume       = {83},
      number       = {4},
      issn         = {2168-622X},
      address      = {Chicago, Ill.},
      publisher    = {AMA},
      reportid     = {DZNE-2026-00354},
      pages        = {353},
      year         = {2026},
      abstract     = {Substance use disorder (SUD) is commonly found in
                      individuals with schizophrenia, with a high co-occurrence
                      rate of approximately $41.7\%.$ Despite this high
                      prevalence, people with both schizophrenia and SUD are
                      frequently excluded from clinical trials and systematic
                      reviews; this special group is particularly challenging to
                      treat and imposes a significant economic burden on health
                      care systems.To evaluate the efficacy, acceptability, and
                      tolerability of psychological and psychosocial interventions
                      in patients with schizophrenia and co-occurring SUD.The
                      Cochrane Schizophrenia Group registry was searched up to
                      January 13, 2025. Data analysis was performed from March to
                      April 2025.Randomized clinical trials (RCTs) examining
                      psychological and psychosocial interventions compared with
                      control groups in adults with schizophrenia and concomitant
                      SUD were identified. No restrictions were applied regarding
                      the type of substance used, including alcohol, cannabis,
                      nicotine, and stimulants, such as amphetamines.A systematic
                      review and random-effect pairwise meta-analyses were
                      conducted to estimate standardized mean differences (SMD)
                      with $95\%$ confidence intervals and were reported following
                      Preferred Reporting Items for Systematic Reviews and
                      Meta-Analyses (PRISMA) reporting guidelines. Confidence in
                      the estimate was assessed with the Grading of
                      Recommendations Assessment, Development and Evaluation
                      (GRADE) approach.The primary outcomes were overall symptoms
                      and substance use reduction measured by validated scales at
                      posttreatment.A total of 35 RCTs were included (4136
                      participants), with 29 trials involving 3831 participants
                      contributing to pairwise meta-analyses comparing
                      psychological and psychosocial interventions with control
                      conditions. Among the 3748 participants with reported sex,
                      951 $(25.4\%)$ were female, and mean (range) age was 37.2
                      (20.6-57.5) years. A very small effect favoring the
                      intervention group was observed in reducing overall symptoms
                      (SMD, -0.11; $95\%$ CI, -0.27 to 0.05; 13 trials; low
                      confidence in the estimate), mainly driven by nicotine
                      studies. No difference was found between intervention and
                      control groups in reducing all types of substance use (SMD,
                      -0.01; $95\%$ CI, -0.21 to 0.18; 8 trials; moderate
                      confidence). When considered separately, alcohol, cannabis,
                      amphetamines, and other stimulants showed similar no-effect
                      results, while nicotine use indicated a small effect.The
                      findings of this systematic review and meta-analysis suggest
                      that current psychological and psychosocial interventions
                      provide limited benefit in reducing symptoms and no effect
                      in reducing substance use in individuals with schizophrenia
                      and SUD compared to control conditions, with the exception
                      of nicotine use, highlighting the urgent need to develop
                      more effective treatment strategies.},
      keywords     = {Humans / Substance-Related Disorders: therapy /
                      Substance-Related Disorders: epidemiology /
                      Substance-Related Disorders: complications / Schizophrenia:
                      therapy / Schizophrenia: epidemiology / Psychosocial
                      Intervention: methods / Comorbidity / Psychotherapy: methods
                      / Diagnosis, Dual (Psychiatry) / Randomized Controlled
                      Trials as Topic},
      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:41637064},
      pmc          = {pmc:PMC12874077},
      doi          = {10.1001/jamapsychiatry.2025.4390},
      url          = {https://pub.dzne.de/record/285818},
}