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Overoptimistic Literature and Methodological Biases Favoring Cognitive Behavioral Therapy for the Prevention of Psychosis

Indicated prevention in young people at Clinical High Risk for Psychosis (CHR-P) originated in Australia more than 20 years ago1 and subsequently impacted national and international clinical guidelines2 and diagnostic manuals.3 While the most recent umbrella reviews (reviews of meta-analyses) demonstrated substantial achievements in detection and prognostic assessment of young CHR-P individuals,4 the most updated network meta-analysis found no robust evidence to favor cognitive behavioral therapy (CBT) compared with the control condition (ie, needs-based interventions).5 An independent pairwise meta-analysis by the Cochrane group corroborated these findings, concluding “there was no convincing unbiased, high-quality evidence” that any type of intervention is more effective than needs-based interventions6 (two other pairwise meta-analyses were published7,8 but either used older data7 than the network and Cochrane meta-analyses or were discussed elsewhere, with significant concerns in regard to study inclusion8,9). Overall, these studies cautioned that uncertainty of evidence is high for CBT in preventing psychosis among CHR-P individuals.5,6,10

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Posted in: Journal Article Abstracts on 11/17/2021 | Link to this post on IFP |
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