Comparison of effectiveness of various psychotherapeutic approaches to first-episode psychosis in terms of recovery: systematic review

An exploratory systematic mixed-methods review was conducted, comparing effectiveness of various psychotherapeutic approaches and psychological factors to first-episode psychosis (FEP) with emphasis on symptomatic and... [ view full abstract ]

An exploratory systematic mixed-methods review was conducted, comparing effectiveness of various psychotherapeutic approaches and psychological factors to first-episode psychosis (FEP) with emphasis on symptomatic and functional recovery. The review builds on state-of-the-art findings in FEP research and critically assesses rationale of existing clinical procedures. A broad search strategy led to identification of 2238 research studies: 33 studies (published from 2000-2016) meeting inclusion criteria were examined in detail. Applied interventions were: cognitive-behavioral therapy (13), group interventions on the basis of family and community psychiatry (8), psychodynamic psychotherapy (5), combination of various interventions within integrated models of care (6) and another type of intervention (1). Mean age of respondents was 24.3 years, males comprised 61%. Effectiveness was assessed within the Three-dimensional model of outcome measurement by Rosenblatt and Attkisson. Included studies most frequently described effectiveness of applied intervention in terms of clinical status (57%), functional status (25%), measures of life satisfaction and fulfillment (15%) and least at measures of safety and welfare (3%). Based on clinical consideration, particular factors of most effective interventions were identified. These factors were organized into table of recovery preconditions, which constitute optimal approach to FEP. The results emphasize indispensability of psychotherapeutic approaches in FEP treatment.