Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults

A systematic review and meta-analysis

Megan R. Stafford, Evan R Mayo-Wilson, Christina E. Loucas, Anthony James, Chris Hollis, Max Birchwood, Tim Kendall

Research output: Contribution to journalArticle

Abstract

Background: Studies report contrasting results regarding the efficacy and safety of pharmacological, psychological, and combined interventions in psychosis and schizophrenia in children, adolescents and young adults. Methods: Systematic review and meta-analysis. Embase, Medline, PreMedline, PsycINFO, and CENTRAL were searched to July 2013 without restriction to publication status. Randomised trials comparing any pharmacological, psychological, or combined intervention for psychosis and schizophrenia in children, adolescents and young adults were included. Studies were assessed for bias, and GRADE criteria were used to describe the quality of the results. Results: Twenty-seven trials including 3067 participants were identified. Meta-analyses were performed for 12 comparisons: symptoms, relapse, global state, psychosocial functioning, depression, weight and discontinuation. Low quality evidence demonstrated that antipsychotics have small beneficial effects on psychotic symptoms (SMD = -0.42, 95% CI -0.58 to -0.26), and a medium adverse effect on weight gain (WMD = 1.61, 95% CI 0.61 to 2.60) and discontinuation due to side effects (RR = 2.44, 95% CI, 1.12 to 5.31). There were no trials of psychological treatments in under-18 year olds. There was no evidence of an effect of psychological interventions on psychotic symptoms in an acute episode, or relapse rate, but low quality evidence of a large effect for family plus individual CBT on the number of days to relapse (WMD = 32.25, 95% CI -36.52 to -27.98). Conclusions: For children, adolescents and young adults, the balance of risk and benefit of antipsychotics appears less favourable than in adults. Research is needed to establish the potential for psychological treatments, alone and in combination with antipsychotics, in this population.

Original languageEnglish (US)
Article numbere0117166
JournalPLoS One
Volume10
Issue number2
DOIs
StatePublished - Feb 11 2015
Externally publishedYes

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systematic review
young adults
meta-analysis
Psychotic Disorders
Antipsychotic Agents
Meta-Analysis
Young Adult
Schizophrenia
relapse
Pharmacology
Psychology
Safety
Recurrence
Surface mount technology
adverse effects
Therapeutics
weight gain
Weight Gain
Publications
schizophrenia

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults : A systematic review and meta-analysis. / Stafford, Megan R.; Mayo-Wilson, Evan R; Loucas, Christina E.; James, Anthony; Hollis, Chris; Birchwood, Max; Kendall, Tim.

In: PLoS One, Vol. 10, No. 2, e0117166, 11.02.2015.

Research output: Contribution to journalArticle

Stafford, Megan R. ; Mayo-Wilson, Evan R ; Loucas, Christina E. ; James, Anthony ; Hollis, Chris ; Birchwood, Max ; Kendall, Tim. / Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults : A systematic review and meta-analysis. In: PLoS One. 2015 ; Vol. 10, No. 2.
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