Treatment-Resistant to Antipsychotics: A Resistance to Everything? Psychotherapy in Treatment-Resistant Schizophrenia and Nonaffective Psychosis: A 25-Year Systematic Review and Exploratory Meta-Analysis
Bibliographic record
Abstract
Background: Approximately 30% of schizophrenia patients fail to respond to more than two antipsychotic trials. Psychosis has been traditionally thought to be scarcely accessible to psychotherapy. Nevertheless, there are increasing evidence that psychological interventions could be considered in Treatment Resistant Psychosis (TRP). Despite the relevance of the issue and the emerging neurobiological underpinnings, no systematic reviews have been published. Here we show a systematic review of psychotherapy interventions in TRP patients of the last 25 years. Methods: The MEDLINE/PubMed, ISI WEB of Knowledge and Scopus databases were searched from January 1, 1993 to January 1, 2018, for reports documenting on augmentation or substitution with psychotherapy for Treatment Resistant Schizophrenia (TRS) and TRP patients. Results: Forty-two articles have been found. Cognitive Behavioral Therapy (CBT) was the most frequently recommended psychotherapy intervention for TRS (studies, n=32, 76,2%), showing efficacy for general psychopathology and positive symptoms as documented by most of the studies, but with uncertain efficacy on negative symptoms. Other interventions showed similar results. Group therapy was supported by the appraised evidence. Few studies focused on negative symptoms. Results have also been reported in resistant early psychosis. Limitations: Bias due to the inclusion of heterogeneous clinical record. Conclusions: CBT, Psychosocial Intervention, Supportive counseling, Psychodynamic psychotherapy and other psychological interventions can be recommended for clinical practice. More studies are needed on treatment of resistant negative symptoms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.003 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".