Family Therapy Evidence Profile

DescriptionStudy IdsQuality of included studiesConsistencyDirectnessOther factorsN treatment groupN controlEffect sizeLikelihood of clinically important effectOverall quality
Family Interventions
Family Intervention vs Individual Intervention
01 Leaving the study early for any reasonRea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse/ imprecise data (−1)2825RR= 1.07 (0.37, 3.08)InconclusiveModerate
01 Number relapsed by end of treatmentRea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse/ imprecise data (−1)2825RR= 0.89 (0.52, 1.54)InconclusiveModerate
02 Number relapsed by 1-year follow-upRea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse data (−1)2825RR= 0.48 (0.24, 0.93)Likely (favoursModerate
03 Number hospitalised at end of treatmentRea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse/ imprecise data (−1)2825RR= 0.71 (0.34, 1.52)InconclusiveModerate
04 Number hospitalised at 1- year follow-upRea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse data (−1)2825RR= 0.39 (0.25, 0.62)Very likely (favoursModerate
01 Medication compliance at endpoint (physician rated)Rea 2003SIGN: 1+ Insufficient details on randomisation; single blindN/AYoung sample; 40% first episodeSparse/ imprecise data (−1)2017WMD= 0.57 (−0.53, 1.67)InconclusiveModerate
Family Intervention vs Crisis Management
01 Leaving the study early for any reasonMiklowitz 2000SIGN: 1++N/AMean 4 previous episodesSparse/ imprecise data (−1)3170RR= 0.36 (0.11, 1.12)InconclusiveLow
01 Number not in remission at 3-month follow-upMiklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse data (−1),3170RR= 0.54 (0.33, 0.89)Likely (favours treatment)Moderate
02 Number not in remission at 15-month follow-upMiklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse data (−1),3170RR= 0.59 (0.39, 0.88)Likely (favours treatment)Moderate
01 SADS-C depression subscale (endpoint)Miklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse data (−1),2851WMD= −0.4 (−0.8, 0)Likely (favours treatment)Moderate
02 SADS-C mania subscale (endpoint)Miklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse/ imprecise data (−1)2851WMD= 0 (−0.4, 0.4)InconclusiveLow
03 SADS-C total (endpoint)Miklowitz 2000SIGN: 1++N/AMean 4 previous episodesSparse data (−1),2851WMD= −0.3 (−0.61, 0.01)Likely (favours treatment)Moderate
04 SADS-C depression subscale (3 month follow up)Miklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse/ imprecise data (−1)2851WMD= −0.1 (−0.56, 0.36)InconclusiveLow
05 SADS-C mania subscale (3 month follow up)Miklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse/ imprecise data (−1)2851WMD= −0.3 (−0.68, 0.08)InconclusiveLow
06 SADS-C total (3 month follow up)Miklowitz 2000SIGN: 1+ Single blindN/AMean 4 previous episodesSparse/ imprecise data (−1)2851WMD= −0.2 (−0.54, 0.14)InconclusiveModerate
Family Therapy vs Multifamily Psychoeducation Group Therapy
01 Leaving the study early for any reasonMiller2004SIGN: 1+ (No details on randomisation)N/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3029RR= 1.02 (0.71, 1.47)InconclusiveLow
01 Number not in remission at end of treatmentMiller2004SIGN: 1+ Insufficient details on randomisation; single blindN/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3029RR= 0.67 (0.34, 1.32)InconclusiveLow
Family Therapy vs Pharmacotherapy
01 Leaving the study early for any reasonMiller2004SIGN: 1+ Insufficient details on randomisation; single blindN/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3329RR= 0.97 (0.67, 1.4)InconclusiveLow
01 Number not in remission at end of treatmentMiller2004SIGN: 1+ Insufficient details on randomisation; single blindN/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3329RR= 1.15 (0.68, 1.94)InconclusiveLow
Multi-family Psychoeducation Group Therapy vs Pharmacotherapy
01 Leaving the study early for any reasonMiller2004SIGN: 1+ Insufficient details on randomisation; single blindN/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3029RR= 1.02 (0.71, 1.47)InconclusiveLow
01 Number not in remission at end of treatmentMiller2004SIGN: 1+ Insufficient details on randomisation; single blindN/AMean previous episodes: manic 8; depressed 5Sparse/ imprecise data (−1)3029RR= 0.67 (0.34, 1.32)InconclusiveLow

From: APPENDIX 23, EVIDENCE PROFILES

Cover of Bipolar Disorder
Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care.
NICE Clinical Guidelines, No. 38.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2006.
Copyright © 2006, The British Psychological Society & The Royal College of Psychiatrists.

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