A Cochrane review [Abstract] 1 included 24 studies with a total of 2126 subjects. Ten studies included only people with schizophrenia, 16 trials included people with other psychotic illnesses (schizoaffective disorder, delusional disorder and other psychoses). The studies were conducted both at inpatients and outpatient settings. All studies used supportive therapy in addition to standard care (including antipsychotic medication). The overall duration of the trials varied between 10 weeks and 3 years. No significant differences in the primary outcomes (relapse, hospitalisation, or general functioning) between supportive therapy and standard care were found. However, there were significant differences favouring other psychological or psychosocial treatments over supportive therapy including hospitalisation rates (RR 1.82, CI 1.11 to 2.99; 4 RCTs, n = 306), clinical improvement in mental state (RR 1.27, CI 1.04 to 1.54; 3 RCTs, n = 194) and satisfaction of treatment for the recipient of care (RR 3.19, CI 1.01 to 10.7; 1 RCT, n = 45). There was no evidence of significant differences for rate of relapse, leaving the study early and quality of life. No significant differences were found, when supportive therapy was compared to cognitive behavioural therapy CBT. There were very limited data to compare supportive therapy with family therapy and psychoeducation, and no studies provided data regarding clinically important change in general functioning, one of our primary outcomes of interest.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), indirectness (differences in patients) and by inconsistency (heterogeneity in interventions and outcomes).
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