Abstract
AbstractAt least half of all patients with mental health disorders do not respond adequately to psychological therapy. Acutely enhancing particular biological or psychological processes during psychological therapy may improve treatment outcomes. However, previous studies are confined to specific augmentation approaches, typically assessed within single diagnostic categories. Our objective was to assess to what degree acute augmentations of psychological therapy reduce psychiatric symptoms and estimate effect sizes of augmentation types (for example, brain stimulation or psychedelics). We searched Medline, PsycINFO and Embase for controlled studies published between database inception and 25 May 2022. We conducted a preregistered random-effects meta-analysis (PROSPERO CRD42021236403). We identified 108 studies (N = 5,889). Acute augmentation significantly reduced the severity of mental health problems (Hedges’g = −0.27, 95% CI: [−0.36, −0.18];P < 0.0001), particularly for the transdiagnostic dimensions 'Fear' and 'Distress'. This result survived a trim-and-fill analysis to account for publication bias. Subgroup analyses revealed that pharmacological, psychological and somatic augmentations were effective, but to varying degrees. Acute augmentation approaches are a promising route to improve outcomes from psychological therapy.
Funder
RCUK | Medical Research Council
AXA Research Fund
Publisher
Springer Science and Business Media LLC
Reference147 articles.
1. Depression and Other Common Mental Disorders (WHO, 2017); http://apps.who.int/iris/bitstream/handle/10665/254610/WHOMSD?sequence=1
2. O’Shea, N. & Bell, A. A Spending Review for Wellbeing (Centre for Mental Health, 2020); https://www.centreformentalhealth.org.uk/sites/default/files/publication/download/CentreforMentalHealth_SpendingReviewForWellbeing.pdf
3. Ormel, J., Hollon, S. D., Kessler, R. C., Cuijpers, P. & Monroe, S. M. More treatment but no less depression: the treatment–prevalence paradox. Clin. Psychol. Rev. 91, 102111 (2021).
4. Lazar, S. G. & Gabbard, G. O. The cost-effectiveness of psychotherapy. J. Psychother. Pract. Res. 6, 307–314 (1997).
5. Zimmermann, G., Favrod, J., Trieu, V. & Pomini, V. The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis. Schizophr. Res. 77, 1–9 (2005).