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Cognitive–behavioural therapy for personal recovery of patients with schizophrenia: A systematic review and meta-analysis
  1. Weiliang Wang1,
  2. Yuqiu Zhou1,
  3. Nannan Chai2 and
  4. Dongwei Liu1
  1. 1 School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
  2. 2 School of Nursing, Chifeng University, Chifeng, Inner Mongolia Autonomous Region, China
  1. Correspondence to Professor Yuqiu Zhou, Harbin, China; hmuhlxy{at}163.com

Abstract

Background To date, cognitive–behavioural therapy (CBT) trials have primarily focused on clinical recovery; however, personal recovery is actually the fundamental aspect of the recovery process. The aim of this study was to summarise and synthesise the existing evidence regarding the effectiveness of CBT for personal recovery in patients with schizophrenia.

Aim This study aimed to determine the effectiveness of CBT for personal recovery in patients with schizophrenia.

Methods A systematic search of the literature in PsycINFO, PubMed, Cochrane (CENTRAL), Embase and Web of Science (SCI) was conducted to identify randomised controlled trials reporting the impact of CBT interventions on personal recovery in patients with schizophrenia. The estimated effect sizes of the main study outcomes were calculated to estimate the magnitude of the treatment effects of CBT on personal recovery. We also evaluated the CBT’s effect size at the end-of-treatment and long-term (follow-up) changes in some aspects of personal recovery.

Results Twenty-five studies were included in the analysis. The effect of CBT on personal recovery was 2.27 (95% CI 0.10 to 4.45; I2=0%; p=0.04) at post-treatment and the long-term effect size was 2.62 (95% CI 0.51 to 4.47; I2=0%; p=0.02). During the post-treatment period, the pooled effect size of CBT was 0.01 (95% CI −0.12 to 0.15; I2=33.0%; p>0.05) for quality of life (QoL), 0.643 (95% CI 0.056 to 1.130; I2=30.8%; p<0.01) for psychological health-related QoL, −1.77 (95% CI −3.29 to −0.25; I2=40%; p=0.02) for hopelessness and 1.85 (95% CI 0.69 to 3.01; I2=41%; p<0.01) for self-esteem. We also summarised the effects of CBT on QoL (subscale scores not included in the evaluation of the pooled effect size), self-confidence and connectedness, and all results corresponded to positive effects. However, there was insufficient evidence regarding the long-term effects of CBT on personal recovery.

Conclusions CBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment. However, the effect is relatively immediate and rapidly decreases as time progresses. Therefore, in the future, more studies should focus on the mechanism of CBT for personal recovery and the factors that influence the long-term effects of CBT.

Trial registration number CRD42018085643.

  • cognitive–behavioural therapy
  • schizophrenia
  • personal recovery
  • systematic review
  • meta-analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors WW and ZY designed the study and contributed substantially to the design of the search strategy. WW and NC searched the literature and extracted the data. DL performed the analysis and interpreted the data. WW wrote the first draft of the manuscript and YZ critically reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the National Natural Science Foundation of China (Grant No: 71673070).

  • Disclaimer The sponsor had no role in the study design, writing of the manuscript, or decision to submit this or future manuscripts for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data generated or analysed during this study are included in this article.

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