Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis

  1. Morales-Pillado, Carla 12
  2. Fernández-Castilla, Belén 3
  3. Sánchez-Gutiérrez, Teresa 2
  4. González-Fraile, Eduardo 2
  5. Barbeito, Sara 2
  6. Calvo, Ana 1
  1. 1 Universidad Complutense de Madrid
    info

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

  2. 2 Universidad Internacional de La Rioja
    info

    Universidad Internacional de La Rioja

    Logroño, España

    ROR https://ror.org/029gnnp81

  3. 3 Universidad Nacional de Educación a Distancia
    info

    Universidad Nacional de Educación a Distancia

    Madrid, España

    ROR https://ror.org/02msb5n36

Revista:
Psychological Medicine

ISSN: 0033-2917 1469-8978

Año de publicación: 2022

Volumen: 53

Número: 13

Páginas: 6304-6315

Tipo: Artículo

DOI: 10.1017/S0033291722003610 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Psychological Medicine

Resumen

AbstractBackgroundTechnology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis.MethodsRandomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis.ResultsFifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09–0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46–2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology.ConclusionsTBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.

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