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Meta-Analysis
. 2023 Oct;53(13):6304-6315.
doi: 10.1017/S0033291722003610. Epub 2022 Dec 6.

Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis

Carla Morales-Pillado  1   2 , Belén Fernández-Castilla  3 , Teresa Sánchez-Gutiérrez  2 , Eduardo González-Fraile  2 , Sara Barbeito  2 , Ana Calvo  1
Affiliations
Meta-Analysis

Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis

Carla Morales-Pillado et al. Psychol Med. 2023 Oct.

Abstract

Background: Technology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis.

Methods: Randomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis.

Results: Fifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09-0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46-2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology.

Conclusions: TBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.

Keywords: eHealth; internet; mHealth; online interventions; psychosis; smartphone.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Network plot for the interventions for the different outcomes. Neurocognition (all studies, k = 351); symptomatology (all studies, k = 130); functioning (all studies, k = 130); social cognition (all studies, k = 46); quality of life (all studies, k = 40). The thickness of the lines is proportional to the number of studies that reported the comparison between those treatments. CG, control group.
See this image and copyright information in PMC

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