Evidenzbasierte Leitlinie zur Psychotherapie von Schizophrenie und anderen psychotischen Störungen

Lincoln, Tania M.; Pedersen, Anya; Hahlweg, Kurt; Wiedl, Karl H.; Frantz, Inga

doi:10.1026/02883-000

Cited by 26 publications

(20 citation statements)

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“…Different national treatment guidelines have recommended different psychological therapies to treat the negative symptoms of schizophrenia (e.g., DGPPN e.V., 2019;Lincoln et al, 2019;NICE, 2014). The purpose of such recommendations is to inform clinicians about which treatments to offer to their patients who experience these symptoms (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…An important question then is, whether our findings accord with published treatment guidelines. For example, based on previous RCTs and meta-analyses in schizophrenia samples (e.g., Granholm, Holden, Link, & McQuaid, 2014;Kurtz & Mueser, 2008;Turner et al, 2018Turner et al, , 2014, the German treatment guidelines (DGPPN e.V., 2019;Lincoln et al, 2019) recommend Social Skills Training (SST) for negative symptoms. As we did not identify any study that tested SST in the target group, we argue that there is little evidence to support this recommendation.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of CBT, the effect was not significant in a more recent metaanalysis (Velthorst et al, 2015). Among studies comparing different active psychological interventions to one another, SST seems to be superior to other treatments (Turner, van der Gaag, Karyotaki, & Cuijpers, 2014) and is recommended for negative symptoms in two German treatment guidelines (DGPPN e.V., 2019;Lincoln, Pedersen, Hahlweg, Wiedl, & Frantz, 2019). According to the British NICE guidelines (NICE, 2014), offering arts therapy (including music and body-oriented therapy) should be considered both in acute phases and "to assist in promoting recovery, particularly in people with negative symptoms" (p. 220).…”

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confidence: 98%

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Efficacy of psychological treatments for patients with schizophrenia and relevant negative symptoms: A meta-analysis

Riehle

Böhl

Pillny

et al. 2020

Clin. Psychol. Eur.

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Background Recent meta-analyses on the efficacy of psychological treatments for the negative symptoms of schizophrenia included mostly trials that had not specifically targeted negative symptoms. To gauge the efficacy of such treatments in the target patient population – namely people with schizophrenia who experience negative symptoms – we conducted a meta-analysis of controlled trials that had established an inclusion criterion for relevant negative symptom severity. Method We conducted a systematic literature search and calculated random-effects meta-analyses for controlled post-treatment effects and for pre-post changes within treatment arms. Separate analyses were conducted for different therapeutic approaches. Our primary outcome was reduction in negative symptoms; secondary outcomes were amotivation, reduced expression, and functioning. Results Twelve studies matched our inclusion criteria, testing Cognitive Behavioral Therapy (CBT) vs. treatment-as-usual (k = 6), Cognitive Remediation (CR) vs. treatment-as-usual (k = 2), CBT vs. CR (k = 2), and Body-oriented Psychotherapy (BPT) vs. supportive group counseling and vs. Pilates (k = 1 each). Accordingly, meta-analyses were performed for CBT vs. treatment-as-usual, CR vs. treatment-as-usual, and CBT vs. CR. CBT and CR both outperformed treatment-as-usual in reducing negative symptoms (CBT: Hedges’ g = -0.46; CR: g = -0.59). There was no difference between CBT and CR (g = 0.12). Significant pre-post changes were found for CBT, CR, and to a lesser extent for treatment-as-usual, but not for BPT. Conclusion Although effects for some approaches are promising, more high-quality trials testing psychological treatments for negative symptoms in their target population are needed to place treatment recommendations on a sufficiently firm foundation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

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Efficacy of psychological treatments for patients with schizophrenia and relevant negative symptoms: A meta-analysis

Riehle

Böhl

Pillny

et al. 2020

Clin. Psychol. Eur.

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“…A systematic search for methodologically sound meta-analyses via Web of Science, PsycINFO, PSYNDEX, and Medline was conducted to establish a German guideline for the psychological treatment of schizophrenia and psychotic disorders (Lincoln, Pedersen, Hahlweg, Wiedl, & Frantz, 2019). This guideline was initiated by the German Society for Clinical Psychology and Psychotherapy as an adjunct to the S-3 German guideline, which has a broader focus.…”

Section: Methods Of the Reviewmentioning

confidence: 99%

“…Finally, we disregarded any reported effect-size based on one original study only. Readers seeking more detailed evidence reports are referred to the British or German guidelines (Lincoln et al, 2019;, and to the original meta-analyses cited.…”

Section: Limitations Of This Analysismentioning

confidence: 99%

An Overview of the Evidence for Psychological Interventions for Psychosis: Results From Meta-Analyses

Lincoln

Pedersen

2019

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There are numerous psychological approaches to psychosis that differ in focus, specificity and formats. These include psychodynamic, humanistic, cognitive-behavioural and third-wave-approaches, psychoeducation, various types of training-based approaches and family interventions. We briefly describe the main aims and focus of each of these approaches, followed by a review of their evidence-base in regard to improvement in symptoms, relapse and functioning. We conducted a systematic search for meta-analyses dating to 2017 for each of the approaches reviewed. Where numerous meta-analyses for an approach were available, we selected the most recent, comprehensive and methodologically sound ones. We found convincing short- and long-term evidence for cognitive behavioural approaches if the main aim is to reduce symptom distress. Evidence is also strong for psychoeducative family interventions that include skills training if the main aim is to reduce relapse and rehospitalisation. Acceptance and commitment therapy, mindfulness-based approaches, meta-cognitive and social skills training, as well as systemic family interventions, were also found to be efficacious, depending on the outcome of interest, but meta-analyses for these approaches were based on a comparatively lower number of outcome studies and a narrower selection of outcome measures. We found no convincing evidence for psychodynamic approaches, humanistic approaches or patient-directed psychoeducation (without including the family). An array of evidence-based psychological therapies is available for psychotic disorders from which clinicians and patients can choose, guided by the strength of the evidence and depending on the outcome area focused on. Increased effort is needed in terms of dissemination and implementation of these therapies into clinical practice. Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms. Meta-analyses show convincing evidence for family interventions if the main target is relapse. Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed. The array of effective approaches allows clinicians and patients to select the most appropriate one. Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms. Meta-analyses show convincing evidence for family interventions if the main target is relapse. Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed. The array of effective approaches allows clinicians and patients to select the most appropriate one.

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‘You are trying to teach us to think more slowly!’: Adapting Metacognitive Training for the acute care setting—A case report

Fischer

Scheunemann

Bohlender

et al. 2022

Clin Psychology and Psychoth

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Psychological group interventions for the acute inpatient care setting are scarce. Whereas Metacognitive Training for patients with Psychosis (MCT) provides a widely accessible, easy‐to‐implement intervention for patients with mild to moderate symptoms, it is less adequate for the acute care setting with respect to length and density of information. We present the adaptation process and the resulting adaptation of MCT, MCT‐Acute, for the acute inpatient care setting. We report the case of a first patient, NK, who participated in MCT‐Acute during her mandated stay on the locked acute ward due to an exacerbation of schizophrenia. NK participated in MCT‐Acute 12 times, evaluated the training overall as positive and reported that she used exercises she had learned during training to improve her mood. She also described changing her behaviour in everyday life to think more slowly and make less hasty decisions, which is a central topic discussed in MCT and MCT‐Acute. Conducting an adapted version of MCT in the acute care setting is feasible, and the present case report suggests that MCT‐Acute may be a useful complement to a multidisciplinary treatment plan to stabilize patients with severe mental illness in acute inpatient care.

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Evidenzbasierte Leitlinie zur Psychotherapie von Schizophrenie und anderen psychotischen Störungen

Cited by 26 publications

References 0 publications

Efficacy of psychological treatments for patients with schizophrenia and relevant negative symptoms: A meta-analysis

Efficacy of psychological treatments for patients with schizophrenia and relevant negative symptoms: A meta-analysis

An Overview of the Evidence for Psychological Interventions for Psychosis: Results From Meta-Analyses

‘You are trying to teach us to think more slowly!’: Adapting Metacognitive Training for the acute care setting—A case report

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