CPG for Psychosocial Interventions in Severe Mental ... - GuÃaSalud

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Figure 1. Search Strategy Search for CPGs in GuíaSalud National Guidelines Clearinghouse Trip Database G-I-N 26 CPGs identifi ed selected those that contained psychosocial interventions First selection 5 CPGs selected Each CPG was Assessed by 4 reviewers AGREE Instrument Cut-off values was established: score > 75% in area 3 3 CPGs selected Each one of the 5 CPGs selected was assessed by 4 independent reviewers. The cut-off values to accept the guidelines was set at 60%, except for the methodology section, area 3: rigour and preparation, where the cut-off had to be over 75%. Finally, only 3 CPG passed the established cut-off value: The CPGs on Schizophrenia, Bipolar Disorder and Compulsive Obsessive Disorder developed by the National Institute for Health and Clinical Excellence of the United Kingdom (NICE) 7,8,9 , and it was decided to use them as a secondary source of evidence that would help answer some specific aspects. Once the part corresponding to the identification and analysis of published CPGs had ended, in order to make the bibliographic search for relevant evidence that might respond to the questions of the CPG formulated previously, it was established that the following general databases would be consulted: Medline, Cochrane Library, Embase and PsycINFO. Furthermore, different websites, entities and associations were consulted, such as the Centre for Reviews and Dissemination (CRD), NICE, American Psychiatric Association (APA), and ClinicaltrIals.gov. Mesh term and free language were used for the search strategy in order to improve the sensitivity and specificity of the search. The search was restricted to systematic reviews of randomised control trials and original studies of randomised and non-randomised control trials and to English, French, Portuguese and Spanish languages. A hand search was also carried out to review the references of the identified, included or excluded studies. A hand search was carried out in scientific magazines to obtain information on some aspects of the CPG . Due to the lack of quality evidence relating to some specific aspects of the questions, an extended search for original observational studies and case series was carried out, and grey literature (conferences, unpublished reports, etc.) at national and international level, was consulted. Before finishing the CPG, a final search was carried out for recently published articles (until December 2008) that might help answer some of the questions of the CPG. It was then critically 26 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS
appraised them to assess the quality of the article and determine if it could be included in the evidence used to formulate the recommendations. No articles published after that date was included as a source of evidence for the CPG (See figure 2). Prior to the publication of this guideline, a preliminary draft was brought out with the update of the Schizophrenia CPG prepared by the NICE 10 . This document was reviewed by this guideline development group to analyse the possible contributions and/or changes that had arisen in this new update and that might modify the recommendations of the previous schizophrenia guideline 8 published by the NICE, too. Figure 2. Article selection Search in database Medline Embase PsycINFO Cochrane Library 1726 articles identified Selection by title and abstract 499 articles selected Selection by full text 113 articles selected Manual search 76 articles selected Selection by complete text 3.3. Evidence assessment and synthesis Once the bibliographic search had finalised, a first screening of the articles found was carried out. Articles were rejected which, according to the title or abstract, could not respond to the questions. With the remaining articles, those whose title and abstract appeared to be useful, a second screening was carried out and a first reading was done to see if they could answer some of the questions of the CPG. Afterwards, the quality of those articles that had passed the two screenings was assessed, using the OSTEBA (OST FLCritica) critical appraisal tool. To classify the evidence of the effectiveness of the interventions selected, the modified hierarchic classification system of the Scottish Intercollegiate Guidelines Network, SIGN 6 (appendix 1) was used, and the data obtained from the selected articles were dumped onto a grid for assessment and subsequent development of the guideline recommendations (appendix 3). CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 27
Page 1: Clinical Practice Guidelines for Ps
Page 4 and 5: This CPG is an aid for decision mak
Page 7 and 8: Table of Contents Presentation 7 Au
Page 9 and 10: Presentation Healthcare practice is
Page 11 and 12: Authorship and collaborators CPG de
Page 13: José Manuel Lalana Cuenca. Special
Page 16 and 17: c) SERVICE LEVEL INTERVENTIONS •
Page 18 and 19: A B A A B B B C Psychosocial inter
Page 20 and 21: B B B C A C C 5.3. SERVICE LEV
Page 22 and 23: 20 CLINICAL PRACTICE GUIDELINES IN
Page 24 and 25: independence, quality of life, pers
Page 26 and 27: This guideline is aimed at mental h
Page 30 and 31: The highest evidence level found wa
Page 33 and 34: 4. Characteristics of the CPG 4.1.
Page 35 and 36: The main focus of rehabilitation is
Page 37 and 38: 5. Psychosocial type rehabilitation
Page 39 and 40: From another point of view, social
Page 41 and 42: defined as “standard care” or
Page 43 and 44: General global state In the short r
Page 45 and 46: Specific symptoms: when CBT was com
Page 47 and 48: In the systematic review by Kurtz a
Page 49 and 50: Summary of evidence 1- 1- 1- 1- 1-
Page 51 and 52: People with SMI and a diagnosis of
Page 53 and 54: 5.1.3. Interpersonal therapy The li
Page 55 and 56: weekly or fortnightly sessions. The
Page 57 and 58: 5.1.5. Family interventions There a
Page 59 and 60: In the RCT carried out by Hogarty e
Page 61 and 62: A family intervention of more than
Page 63 and 64: After two years’ treatment, and b
Page 65 and 66: Family intervention vs. other psych
Page 67 and 68: 1- 1- 1- 1- 1- 1- 1- 1- 1+ No diffe
Page 69 and 70: Question to be answered • Are pys
Page 71 and 72: Summary of evidence Pyschoeducation
Page 73 and 74: with schizophrenia and that the tre
Page 75 and 76: With reference to the type of train
Page 77 and 78: would normally receive and which in
Page 79 and 80:
Hypnosis vs. relaxation No improvem
Page 81 and 82:
Supervised fl ats are a community h
Page 83 and 84:
3 Programmes directed to leisure an
Page 85 and 86:
SMI (schizophrenia, affective schiz
Page 87 and 88:
When PVT is compared with standard
Page 89 and 90:
Patients included in the individual
Page 91 and 92:
1+ 1+ 1++ 1+ 1+ 1+ 1+ The people in
Page 93 and 94:
Music therapy Music therapy + stand
Page 95 and 96:
A series of Case Management systems
Page 97 and 98:
• The satisfaction data originati
Page 99 and 100:
Loss of contact With respect to the
Page 101 and 102:
There is not sufficient evidence, e
Page 103 and 104:
1+ 1+ 1+ 1+ Respect to ICM teams or
Page 105 and 106:
Finally, in the RCT by Cheng et al
Page 107 and 108:
5.4.2. “Homeless” with SMI The
Page 109 and 110:
Patients who access housing with no
Page 111:
ceptive disorders. This series of c
Page 115 and 116:
7. Recommendations for Future Resea
Page 117:
Appendices
Page 120 and 121:
Appendix 2. Information obtained fr
Page 122 and 123:
Appendix 4. Information for people
Page 124 and 125:
4. Regulatory and legal framework 1
Page 126 and 127:
Several protocols have been publish
Page 128 and 129:
The coordination of these resources
Page 130 and 131:
Social protection systems Pursuant
Page 132 and 133:
Specifi c regulation • (SPANISH)
Page 134 and 135:
Service Management: The first anti-
Page 136 and 137:
on Mental Health and the future Eur
Page 138 and 139:
Spanish Society of Legal Psychiatry
Page 140 and 141:
Appendix 5. Abbreviations ACT Asser
Page 142 and 143:
Appendix 6. Glossary Therapy adhere
Page 144 and 145:
Appendix 7. Declaration of interest
Page 146 and 147:
15 Rossler W. Psychiatric rehabilit
Page 148 and 149:
53 Graeber DA, Moyers TB, Griffi th
Page 150 and 151:
86 Schooler NR, Keith SJ, Severe JB
Page 152 and 153:
117 Sohlberg MM, Mateer CA. Effecti
Page 154 and 155:
154 López M, García-Cubillana P,
Page 156 and 157:
190 Bond GR, Drake RE. Predictors o
Page 158 and 159:
225 Hurley AD. Individual psychothe
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