Interpreting the Findings of a Meta-analysis of Psychosocial Interventions in Bipolar Disorder

2021 ◽  
Vol 78 (4) ◽  
pp. 448
Author(s):  
Co Co Tong ◽  
Rebecca Strawbridge ◽  
Sameer Jauhar
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Psychosocial Interventions

scholarly journals Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: Network meta-analysis

2017 ◽  
Vol 210 (5) ◽  
pp. 333-341 ◽  
Author(s):  
Mary Lou Chatterton ◽  
Emily Stockings ◽  
Michael Berk ◽  
Jan J. Barendregt ◽  
Rob Carter ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Bipolar Affective Disorder ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
Adjunctive Treatment ◽  
Depression Symptom ◽  
Pool Data ◽  
Symptom Scale ◽  
Meta Analyses

BackgroundFew trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies.AimsTo combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA).MethodSystematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF).ResultsCarer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive–behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores.ConclusionsOnly interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required.

scholarly journals Network meta-analysis: drawing conclusions regarding trials of psychosocial interventions for bipolar disorder

2017 ◽  
Vol 211 (6) ◽  
pp. 334-336
Author(s):  
David J. Miklowitz ◽  
Andrea Cipriani ◽  
Guy M. Goodwin
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Reliability And Validity ◽  
Psychosocial Interventions ◽  
Statistical Technique ◽  
Psychosocial Treatment ◽  
Control Groups ◽  
Treatment Trials ◽  
And Control ◽  
Indirect Comparisons

SummaryNetwork meta-analysis (NMA) is a statistical technique for making direct and indirect comparisons between different treatment and control groups. Despite its many advantages, NMA may be misleading when evaluating networks that are disconnected, inconsistent or of low reliability and validity. We review how well the analysis of trials of adjunctive psychosocial treatment in bipolar disorder is served by NMA. We conclude with recommendations for future treatment trials in bipolar disorder and guidelines for NMAs.

P.331 Meta-analysis on tryptophan catabolites in bipolar disorder

2021 ◽  
Vol 44 ◽  
pp. S61-S62
Author(s):  
K. Hebbrecht ◽  
K. Skorobogatov ◽  
E. Giltay ◽  
M. Morrens
Keyword(s):  
Bipolar Disorder ◽  
Meta Analysis ◽  
Tryptophan Catabolites

scholarly journals A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD

2021 ◽  
Vol 6 (6) ◽  
pp. e005029
Author(s):  
Giulia Turrini ◽  
Federico Tedeschi ◽  
Pim Cuijpers ◽  
Cinzia Del Giovane ◽  
Ahlke Kip ◽  
...  
Keyword(s):  
Low Income ◽  
Asylum Seekers ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Risk Of Bias ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Treatment As Usual ◽  
Refugees And Asylum Seekers

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.

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