scholarly journals Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Shivani Sharma ◽  
Abigail Hucker ◽  
Terry Matthews ◽  
Dominique Grohmann ◽  
Keith R. Laws
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Random Effects ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Autism Spectrum ◽  
Reporting Bias ◽  
Cognitive Behavioural ◽  
Meta Analyses

Abstract Background Anxiety is common in youth on the autism spectrum and cognitive behavioural therapy (CBT) has been adapted to address associated symptoms. The aim of the current systematic review and meta-analysis was to examine the efficacy of CBT for reducing anxiety in autistic youth. Method Searches of PubMed and Scopus databases were undertaken from January 1990 until December 2020. Studies were included if they consisted of randomised controlled trials (RCTs) using CBT to reduce anxiety in autistic youth. Separate random effects meta-analyses assessed anxiety ratings according to informant (clinician; parent; child), both at end-of-trial and at follow-up. Results A total of 19 RCTs met our inclusion criteria (833 participants: CBT N = 487; controls N = 346). Random effects meta-analyses revealed a large effect size for clinician rated symptoms (g = 0.88, 95% CI 0.55, 1.12, k = 11), while those for both parent (g = 0.40, 95% CI 0.24, 0.56; k = 18) and child-reported anxiety (g = 0.25, 95% CI 0.06, 0.43; k = 13) were smaller, but significant. These benefits were not however maintained at follow-up. Moderator analyses showed that CBT was more efficacious for younger children (for clinician and parent ratings) and when delivered as individual therapy (for clinician ratings). Using the Cochrane Risk of Bias 2 tool, we found concerns about reporting bias across most trials. Conclusions The efficacy of CBT for anxiety in autistic youth was supported in the immediate intervention period. However, substantial inconsistency emerged in the magnitude of benefit depending upon who was rating symptoms (clinician, parent or child). Follow-up analyses failed to reveal sustained benefits, though few studies have included this data. It will be important for future trials to address robustness of treatment gains overtime and to further explore inconsistency in efficacy by informant. We also recommend pre-registration of methods by trialists to address concerns with reporting bias.

scholarly journals Personality Disorders and Their Relation to Treatment Outcomes in Cognitive Behavioural Therapy for Depression: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Harry Banyard ◽  
Alex J. Behn ◽  
Jaime Delgadillo
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Treatment Resistance ◽  
Behavioural Therapy ◽  
Risk Of Bias ◽  
Cognitive Behavioural ◽  
Primary Focus ◽  
Effect Of Pd ◽  
Evidence Based Care

Abstract Background Previous reviews indicate that depressed patients with a comorbid personality disorder (PD) tend to benefit less from psychotherapies for depression and thus personality pathology needs to be the primary focus of treatment. This review specifically focused on studies of Cognitive Behavioural Therapy (CBT) for depression examining the influence of comorbid PD on post-treatment depression outcomes. Methods This was a systematic review and meta-analysis of studies identified through PubMed, PsychINFO, Web of Science, and Scopus. A review protocol was pre-registered in the PROSPERO database (CRD42019128590). Results Eleven eligible studies (N = 769) were included in a narrative synthesis, and ten (N = 690) provided sufficient data for inclusion in random effects meta-analysis. All studies were rated as having “low” or “moderate” risk of bias and there was no significant evidence of publication bias. A small pooled effect size indicated that patients with PD had marginally higher depression severity after CBT compared to patients without PD (g = 0.26, [95% CI: 0.10, 0.43], p = .002), but the effect was not significant in controlled trials (p = .075), studies with low risk of bias (p = .107) and studies that adjusted for intake severity (p = .827). Furthermore, PD cases showed symptomatic improvements across studies, particularly those with longer treatment durations (16–20 sessions). Conclusions The apparent effect of PD on depression outcomes is likely explained by higher intake severity rather than treatment resistance. Excluding these patients from evidence-based care for depression is unjustified, and adequately lengthy CBT should be routinely offered.

Cognitive-behavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis

2008 ◽  
Vol 117 (6) ◽  
pp. 403-411 ◽  
Author(s):  
G. J. Hendriks ◽  
R. C. Oude Voshaar ◽  
G. P. J. Keijsers ◽  
C. A. L. Hoogduin ◽  
A. J. L. M. van Balkom
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Late Life ◽  
Behavioural Therapy ◽  
Cognitive Behavioural

scholarly journals Cognitive behavioural therapy for psychosis prevention: a systematic review and meta-analysis

2013 ◽  
Vol 44 (3) ◽  
pp. 449-468 ◽  
Author(s):  
P. Hutton ◽  
P. J. Taylor
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Control Treatment ◽  
Clinical Equipoise ◽  
Random Allocation ◽  
Cognitive Behavioural ◽  
Informed Treatment

BackgroundClinical equipoise regarding preventative treatments for psychosis has encouraged the development and evaluation of psychosocial treatments, such as cognitive behavioural therapy (CBT).MethodA systematic review and meta-analysis was conducted, examining the evidence for the effectiveness of CBT-informed treatment for preventing psychosis in people who are not taking antipsychotic medication, when compared to usual or non-specific control treatment. Included studies had to meet basic quality criteria, such as concealed and random allocation to treatment groups.ResultsOur search produced 1940 titles, out of which we found seven completed trials (six published). The relative risk (RR) of developing psychosis was reduced by more than 50% for those receiving CBT at every time point [RR at 6 months 0.47, 95% confidence interval (CI) 0.27–0.82, p = 0.008 (fixed-effects only: six randomized controlled trials (RCTs), n = 800); RR at 12 months 0.45, 95% CI 0.28–0.73, p = 0.001 (six RCTs, n = 800); RR at 18–24 months 0.41, 95% CI 0.23–0.72, p = 0.002 (four RCTs, n = 452)]. Heterogeneity was low in every analysis and the results were largely robust to the risk of an unpublished 12-month study having unfavourable results. CBT was also associated with reduced subthreshold symptoms at 12 months, but not at 6 or 18–24 months. No effects on functioning, symptom-related distress or quality of life were observed. CBT was not associated with increased rates of clinical depression or social anxiety (two studies).ConclusionsCBT-informed treatment is associated with a reduced risk of transition to psychosis at 6, 12 and 18–24 months, and reduced symptoms at 12 months. Methodological limitations and recommendations for trial reporting are discussed.

scholarly journals Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis

2017 ◽  
Vol 22 (6) ◽  
pp. 731-741 ◽  
Author(s):  
Kishaan Jeyanantham ◽  
Dipak Kotecha ◽  
Devsaagar Thanki ◽  
Rebecca Dekker ◽  
Deirdre A. Lane
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Heart Failure Patients ◽  
Cognitive Behavioural
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