Treating depressive symptoms in psychosis: A network meta-analysis on the effects of non-verbal therapies

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Abstract

AIMS: The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.

MATERIAL AND METHODS: A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs) comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the 'Clinical Trials Assessment Measure for psychological treatments' (CTAM) scale. Cohen's d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.

RESULTS: 10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU), in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44) and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33). Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35) had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81) was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62). Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.

CONCLUSIONS: Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.

Original languageEnglish
Article numbere0140637
Number of pages19
JournalPLoS ONE
Volume10
Issue number10
DOIs
Publication statusPublished - 20-Oct-2015

Keywords

  • RANDOMIZED CONTROLLED-TRIAL
  • COGNITIVE-BEHAVIOR THERAPY
  • GROUP MUSIC-THERAPY
  • YOGA THERAPY
  • 1ST-EPISODE PSYCHOSIS
  • NEGATIVE SYMPTOMS
  • EXERCISE THERAPY
  • RATING-SCALE
  • FOLLOW-UP
  • SCHIZOPHRENIA

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