Table 96Cognitive behavioural therapy vs. any control - subgroup by phase of illness

Outcome or SubgroupkTotal NStatsEffect (95% CI)
24.1 Mortality (at end of treatment)5883RR (M-H, Fixed, 95% CI)0.32 [0.08, 1.30]
 24.1.1 Suicide: (Initial Treatment)00RR (M-H, Fixed, 95% CI)Not estimable
 24.1.2 Suicide: (Acute treatment)2363RR (M-H, Fixed, 95% CI)0.33 [0.03, 3.10]
 24.1.3 Suicide: (Promoting recovery-in service users with persistent symptoms)3520RR (M-H, Fixed, 95% CI)0.31 [0.05, 1.91]
24.2 Mortality (at follow up)5453RR (M-H, Fixed, 95% CI)0.86 [0.28, 2.65]
 24.2.1 Suicide: (Initial treatment)2265RR (M-H, Fixed, 95% CI)4.02 [0.46, 35.24]
 24.2.2 Suicide: at follow-up (Acute treatment)190RR (M-H, Fixed, 95% CI)0.18 [0.01, 3.71]
 24.2.3 Suicide: at follow-up (Promoting recovery-in service users with persistent symptoms)298RR (M-H, Fixed, 95% CI)0.37 [0.04, 3.47]
24.3 Service outcome: 1. Hospital admission (up to 24 months FU)71006RR (M-H, Random, 95% CI)0.88 [0.71, 1.09]
 24.3.1 At follow up (up to 24 months FU) (Initial treatment)2265RR (M-H, Random, 95% CI)0.95 [0.69, 1.31]
 24.3.2 At follow up (up to 24 months FU) (Acute treatment)2168RR (M-H, Random, 95% CI)0.70 [0.44, 1.10]
 24.3.3 At follow up (up to 24 months FU) (Promoting recovery-in service users with persistent symptoms)3573RR (M-H, Random, 95% CI)0.93 [0.59, 1.47]
24.4 Global state: 1. Relapse (at end of treatment)2122RR (M-H, Fixed, 95% CI)0.63 [0.28, 1.44]
 24.4.1 Relapse: (Initial treatment)00RR (M-H, Fixed, 95% CI)Not estimable
 24.4.2 Relapse: (Acute treatment)00RR (M-H, Fixed, 95% CI)Not estimable
 24.4.3 Relapse: (Promoting recovery-in service users with persistent symptoms)2122RR (M-H, Fixed, 95% CI)0.63 [0.28, 1.44]
24.5 Global state: 1. Relapse (at 24 months follow up)4466RR (M-H, Fixed, 95% CI)1.05 [0.85, 1.30]
 24.5.1 Relapse: (Initial treatment)1203RR (M-H, Fixed, 95% CI)1.01 [0.79, 1.29]
 24.5.2 Relapse: (Acute treatment)188RR (M-H, Fixed, 95% CI)0.97 [0.54, 1.78]
 24.5.3 Relapse: (Promoting recovery-in service users with persistent symptoms)2175RR (M-H, Fixed, 95% CI)1.24 [0.73, 2.12]
24.6 Mental State: 1. Total symptom score (end of treatment) (lower = better)7SMD (IV, Random, 95% CI)Subtotals only
 24.6.1 Total symptom score (Initial treatment)3258SMD (IV, Random, 95% CI)−0.07 [−0.32, 0.18]
 24.6.2 Total symptom score (Acute treatment) (all data)4355SMD (IV, Random, 95% CI)−0.59 [−1.15, −0.04]
 24.6.3 Total symptom score (Acute treatment) (England removed)3290SMD (IV, Random, 95% CI)−0.29 [−0.57, −0.00]
24.7 Mental State: 1. Total symptom score (end of treatment) (lower = better)8SMD (IV, Fixed, 95% CI)Subtotals only
 24.7.1 Total symptom score (Promoting recovery-in service users with persistent symptoms)5699SMD (IV, Fixed, 95% CI)−0.20 [−0.35, −0.04]
 24.7.2 Total symptom score (Acute treatment) (England removed)3290SMD (IV, Fixed, 95% CI)−0.26 [−0.49, −0.03]
24.8 Mental State: 1. Total symptom score (up to 6 months follow up) (lower = better)5381SMD (IV, Fixed, 95% CI)−0.29 [−0.50, −0.09]
 24.8.1 Total symptom score (Initial treatment)2183SMD (IV, Fixed, 95% CI)−0.25 [−0.55, 0.05]
 24.8.2 Total symptom score (Acute treatment)163SMD (IV, Fixed, 95% CI)−0.78 [−1.29, −0.27]
 24.8.3 Total symptom score (Promoting recovery-in service users with persistent symptoms)2135SMD (IV, Fixed, 95% CI)−0.13 [−0.47, 0.21]
24.9 Mental State: 1. Total symptom score (at 9–18 months follow up) (lower = better)91205SMD (IV, Random, 95% CI)−0.38 [−0.61, −0.15]
 24.9.1 Total symptom score (Inital treatment)3145SMD (IV, Random, 95% CI)−0.52 [−1.14, 0.10]
 24.9.2 Total symptom score (Acute treatment) (all data)3283SMD (IV, Random, 95% CI)−0.50 [−1.31, 0.32]
 24.9.3 Total symptom score (Acute treatment) (England removed)2218SMD (IV, Random, 95% CI)−0.05 [−0.32, 0.21]
 24.9.4 Total symptom score (Promoting recovery-in service users with persistent symptoms)3559SMD (IV, Random, 95% CI)−0.38 [−0.69, −0.08]
24.10 Mental state: 2. Continuous measures - positive symptoms (at end of treatment) (lower=better)11808SMD (IV, Fixed, 95% CI)−0.12 [−0.26, 0.02]
 24.10.1 Positive symptom score (Initial treatment)3229SMD (IV, Fixed, 95% CI)−0.11 [−0.37, 0.15]
 24.10.2 Positive symptom score (Acute treatment)3312SMD (IV, Fixed, 95% CI)−0.13 [−0.36, 0.09]
 24.10.3 Positive symptom score (Promoting recovery-in service users with persistent symptoms)5267SMD (IV, Fixed, 95% CI)−0.10 [−0.34, 0.14]
24.11 Mental state: 2. Continuous measures - positive symptoms (up to 12 months follow-up) (lower=better)9708SMD (IV, Fixed, 95% CI)−0.07 [−0.22, 0.08]
 24.11.1 Positive symptom score (Initial treatment)2183SMD (IV, Fixed, 95% CI)−0.16 [−0.46, 0.14]
 24.11.2 Positive symptom score (Acute treatment)3295SMD (IV, Fixed, 95% CI)−0.12 [−0.35, 0.10]
 24.11.3 Positive symptom score (Promoting recovery-in service users with persistent symptoms)4230SMD (IV, Fixed, 95% CI)0.07 [−0.19, 0.33]
24.12 Mental state: 3. Continuous measures - negative symptoms (at end of treatment) (lower=better)12880SMD (IV, Fixed, 95% CI)0.00 [−0.13, 0.13]
 24.12.1 Negative symptom score (Initial treatment)2147SMD (IV, Fixed, 95% CI)0.20 [−0.13, 0.53]
 24.12.2 Negative symptom score (Acute treatment)4378SMD (IV, Fixed, 95% CI)−0.08 [−0.29, 0.12]
 24.12.3 Negative symptom score (Promoting recovery-in service users with persistent symptoms)6355SMD (IV, Fixed, 95% CI)0.01 [−0.20, 0.22]
24.13 Mental state: 3. Continuous measures - negative symptoms (up to 24 months follow up) (lower=better)15SMD (IV, Fixed, 95% CI)Subtotals only
 24.13.1 Negative symptom score (Initial treatment) (all data)5253SMD (IV, Fixed, 95% CI)−0.28 [−0.54, −0.03]
 24.13.3 Negative symptom score (Initial treatment) (LewisL removed)5253SMD (IV, Fixed, 95% CI)−0.28 [−0.54, −0.03]
 24.13.4 Negative symptom score (Acute treatment)4380SMD (IV, Fixed, 95% CI)−0.19 [−0.39, 0.02]
 24.13.5 Negative symptom score (Promoting recovery-in service users with persistent symptoms)6739SMD (IV, Fixed, 95% CI)−0.31 [−0.46, −0.16]
24.14 Treatment acceptability: 1. Leaving the study early (end of treatment)181706RR (M-H, Random, 95% CI)0.89 [0.68, 1.17]
 24.14.1 at end of treatment (Initial treatment)3187RR (M-H, Random, 95% CI)3.35 [0.29, 39.23]
 24.14.2 at end of treatment (Acute treatment)3425RR (M-H, Random, 95% CI)0.92 [0.65, 1.31]
 24.14.3 at end of treatment (Promoting recovery-in service users with persistent symptoms)121094RR (M-H, Random, 95% CI)0.81 [0.57, 1.17]
24.15 Treatment acceptability: 1. Leaving the study early (up to 24 months follow up)151142RR (M-H, Fixed, 95% CI)0.90 [0.75, 1.09]
 24.15.1 follow up (Initial treatment)3340RR (M-H, Fixed, 95% CI)0.73 [0.52, 1.03]
 24.15.2 follow up (Acute treatment)4320RR (M-H, Fixed, 95% CI)1.09 [0.81, 1.46]
 24.15.3 follow up (Promoting recovery-in service users with persistent symptoms)8482RR (M-H, Fixed, 95% CI)0.89 [0.63, 1.26]
24.16 Depression: MADRS, BDI, CDSS (at end of treatment)6933SMD (IV, Fixed, 95% CI)−0.23 [−0.36, −0.10]
 24.16.1 MADRS, BDI, CDSS (initial treatment)191SMD (IV, Fixed, 95% CI)−0.07 [−0.48, 0.34]
 24.16.2 MADRS, BDI, CDSS (acute treatment)2256SMD (IV, Fixed, 95% CI)−0.18 [−0.43, 0.06]
 24.16.3 MADRS, BDI, CDSS (promoting recovery)4586SMD (IV, Fixed, 95% CI)−0.28 [−0.45, −0.11]
24.17 Depression, MADRS, BDI, CDSS (at follow up)5730SMD (IV, Fixed, 95% CI)−0.25 [−0.40, −0.10]
 24.17.1 Depression: BDI, CDSS, MADRS (initial treatment)00SMD (IV, Fixed, 95% CI)Not estimable
 24.17.2 Depression: BDI, CDSS, MADRS (acute treatment)1155SMD (IV, Fixed, 95% CI)−0.16 [−0.48, 0.16]
 24.17.3 Depression: BDI, CDSS, MADRS (promoting recovery)4575SMD (IV, Fixed, 95% CI)−0.28 [−0.44, −0.11]
24.18 Social Functioning measures (SFS, SBS, SOFAS combined) (at end of treatment) (signs reversed)8639SMD (IV, Random, 95% CI)−0.24 [−0.52, 0.05]
 24.18.1 Social functioning (Initial treatment)2153SMD (IV, Random, 95% CI)0.04 [−0.79, 0.86]
 24.18.2 Social functioning (acute treatment)3299SMD (IV, Random, 95% CI)−0.26 [−0.60, 0.09]
 24.18.3 Social functioning (promoting recovery)3187SMD (IV, Random, 95% CI)−0.43 [−1.03, 0.17]
24.19 Social Functioning measures (SFS, SBS, SOFAs combined) (at follow up) (signs reversed)5441SMD (IV, Fixed, 95% CI)−0.19 [−0.37, 0.00]
 24.19.1 Social functioning (Initial treatment)162SMD (IV, Fixed, 95% CI)−0.08 [−0.58, 0.41]
 24.19.2 Social functioning (Acute treatment)3286SMD (IV, Fixed, 95% CI)−0.22 [−0.45, 0.02]
 24.19.3 Social functioning (Promoting recovery)193SMD (IV, Fixed, 95% CI)−0.16 [−0.57, 0.25]

From: 10, Clinical evidence summary tables

Cover of Schizophrenia
Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Update) [Internet].
NICE Clinical Guidelines, No. 82.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2009 Mar.
Copyright © 2009, National Collaborating Centre for Mental Health.

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