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

In the systematic review by Kurtz and Mueser 48 which compares social
skills training with other active therapies or ST, it indicates that the
ES (Effect Size) obtained in the different measurements (from proximal or
execution of trained skills, to distal, which entails the improvement and absence
of relapses) were as follows:
SR (1+)
There is no difference in the execution of trained skills (7 studies, n =
330): ES: 1.20, (95% CI: 0.96 to 1.43). There is some significance in favour
of social skills training in the other measurements: social skills and daily living
(7 studies, n = 481): ES: 0.52, (95% CI: Between 0.34 and 0.71); Social
functioning (7 studies, n = 371): ES: 0.52, (95% CI: between 0.31 and 0.73);
negative symptoms (6 studies, n = 363): ES: 0.40, (95% CI: between 0.19
and 0.61); Other symptoms 10 studies, n = 604): ES: 0.15, (95% CI: between
-0.01 and 0.31); Relapses (9 studies, n = 485): ES: 0.23, (95% CI: between
0.04 and 0.41)
Problem-solving in people with SMI and a diagnosis of schizophrenia and related disorders
Problem-solving vs. standard treatment (ST)
Xia et al 51 indicate that there are no differences between problem-solving
and ST with respect to (1 RCT, n = 12) the problem-solving capacity (RR =
0.20; 95% CI: between 0.03 and 1.2), aggressive behaviour (RR = 0.09; 95%
CI: between 0.01 and 1.35), interaction with staff (RR = 0.09; 95% CI:
between 0.01 and 1.35), interaction with companions (RR = 0.54; 95%
CI: between 0.22 and 1.11)
SR (1+)
Problem-solving vs. coping skills
No differences were detected either between problem-solving and coping skills in the following
parameters:
• Number of admissions (1 RCT; n = 14, RR = 3.00; 95% CI between 0.14 SR (1+)
and 63.15).
• 50% reduction of score in the BPRS scale after treatment (1 RCT; n = 27,
RR = 0.42; 95% CI: between 0.14 and 1.21) or after 6 months (1 RCT; n
= 23, RR = 0.87; 95% CI: between 0.31 and 2.44)
• Early abandonment of study (1 RCT; n = 16, RR = 1.00; 95% CI between
0.07 and 13.37) 51
Motivational interview in cognitive-behavioural therapy (CBT)
Cognitive-behavioural therapy + motivational interview vs. standard treatment
When the motivational interview is included in CBT and it is compared with RCT (1-)
standard treatment, no differences were found in the consumption of substances
between either of the interventions in people with SMI who consume
different types of drugs after 3 months (n=119, WMD=0.37: 95% CI: between
-0.01 and 0.8) or 6 months after the intervention (n=119, WMD=0.19:
95% CI: between -0.2 and 0.6) 57
No improvement was found either in the mental state between the two RCT (1-)
groups (measured with the PANSS scale; (n=32, WMD= -6.59; 95% CI:
between -16.0 and 2.09) 56
CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 45