Interventions and Transition in Youth at Risk of Psychosis: A Systematic Review and Meta-Analysis
Poster B72, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom
Daniel Devoe1, Megan S Farris1, Parker Townes1, Jean Addington1; 1University of Calgary
Objective: The primary objective of this systematic review and meta-analysis was to summarize the impact of all treatments on transition to psychosis in high risk samples. Method: PsycINFO, Embase, CINAHL, EBM, and MEDLINE were searched from inception to May 2017 using keywords psychosis, risk, and treatment with no language restrictions. The following data was extracted: study characteristics (e.g., sample size), participant characteristics (e.g., mean age), and clinical outcome data (e.g., number and percent transited for each intervention group at each time-point and transition assessment employed). Data were analyzed using random-effects pairwise meta-analysis, and secondly, multivariate network meta-analyses (NMA), and reported as risk ratios (RR). Results: A total of 38 independent studies met the inclusion criteria. In pairwise meta-analyses, CBT studies were associated with a significant reduction in transition compared to controls at 12-month and 18-month follow-up (RR= 0.57; 95% CI, 0.35 to 0.93; I2= 7%; P= 0.02 versus RR= 0.54; 95% CI, 0.32 to 0.92; I2= 0%; P= 0.02). In the NMA, integrated psychological therapy, CBT, supportive therapy, family therapy, needs-based interventions, omega-3, risperidone plus CBT, ziprasidone, and olanzapine were not significantly more effective at reducing transition at 6- and 12-months relative to any other intervention. Conclusions: This systematic review and meta-analysis demonstrated a reduced risk for transition favoring CBT at 12- and 18-months. No interventions were significantly more effective at reducing transition compared to all other interventions in the NMA.
Topic Area: Ultra High Risk / Prodromal Research