285818 20260402150927.0 10.1001/jamapsychiatry.2025.4390 doi pmid:41637064 pmid pmc:PMC12874077 pmc 2168-622X ISSN 0003-990X ISSN 0375-8532 ISSN 1538-3636 ISSN 2168-6238 ISSN 2330-9636 ISSN DZNE-2026-00354 English 610 Salahuddin, Nurul Husna 0 Psychological and Psychosocial Interventions for People With Schizophrenia and Co-Occurring Substance Use Disorders: A Systematic Review and Meta-Analysis. Chicago, Ill. 2026 AMA article DRIVER Output Types/Journal article DataCite Journal Article journal journal PUB:(DE-HGF)16 1775135151_16505 PUB:(DE-HGF) ARTICLE BibTeX JOURNAL_ARTICLE ORCID Journal Article 0 EndNote 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. 353 - Clinical and Health Care Research (POF4-353) G:(DE-HGF)POF4-353 POF4-353 POF IV 0 Dataset connected to CrossRef, PubMed, , Journals: pub.dzne.de Humans MeSH Substance-Related Disorders: therapy MeSH Substance-Related Disorders: epidemiology MeSH Substance-Related Disorders: complications MeSH Schizophrenia: therapy MeSH Schizophrenia: epidemiology MeSH Psychosocial Intervention: methods MeSH Comorbidity MeSH Psychotherapy: methods MeSH Diagnosis, Dual (Psychiatry) MeSH Randomized Controlled Trials as Topic MeSH Herlitzius, Emilia 1 Schütz, Alexandra 2 Siafis, Spyridon 3 Priller, Josef P:(DE-2719)2811122 4 dzne Leucht, Stefan 5 Bighelli, Irene 6 10.1001/jamapsychiatry.2025.4390 Vol. 83, no. 4, p. 353 - PERI:(DE-600)2698864-1 4 353 JAMA psychiatry 83 2026 2168-622X Deutsches Zentrum für Neurodegenerative Erkrankungen I:(DE-588)1065079516 DZNE 4 P:(DE-2719)2811122 DE-HGF Gesundheit Neurodegenerative Diseases G:(DE-HGF)POF4-350 G:(DE-HGF)POF4-353 G:(DE-HGF)POF4 G:(DE-HGF)POF4-300 G:(DE-HGF)POF Clinical and Health Care Research 0 JCR StatID:(DE-HGF)0100 StatID JAMA PSYCHIAT : 2022 2024-12-13 DBCoverage StatID:(DE-HGF)0200 StatID SCOPUS 2024-12-13 DBCoverage StatID:(DE-HGF)0300 StatID Medline 2024-12-13 DBCoverage StatID:(DE-HGF)0199 StatID Clarivate Analytics Master Journal List 2024-12-13 DBCoverage StatID:(DE-HGF)1050 StatID BIOSIS Previews 2024-12-13 DBCoverage StatID:(DE-HGF)0160 StatID Essential Science Indicators 2024-12-13 DBCoverage StatID:(DE-HGF)1180 StatID Current Contents - Social and Behavioral Sciences 2024-12-13 DBCoverage StatID:(DE-HGF)1030 StatID Current Contents - Life Sciences 2024-12-13 DBCoverage StatID:(DE-HGF)1190 StatID Biological Abstracts 2024-12-13 DBCoverage StatID:(DE-HGF)0130 StatID Social Sciences Citation Index 2024-12-13 DBCoverage StatID:(DE-HGF)1110 StatID Current Contents - Clinical Medicine 2024-12-13 WoS StatID:(DE-HGF)0113 StatID Science Citation Index Expanded 2024-12-13 DBCoverage StatID:(DE-HGF)0150 StatID Web of Science Core Collection 2024-12-13 IF >= 25 StatID:(DE-HGF)9925 StatID JAMA PSYCHIAT : 2022 2024-12-13 I:(DE-2719)5000007 AG Priller Translational Neuropsychiatry 0 journal EDITORS VDBINPRINT I:(DE-2719)5000007 UNRESTRICTED