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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Forest plot of comparison: 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, outcome: 1.1 Compliance: 1a. With medication ‐ non‐compliance.
Figuras y tablas -
Figure 2

Forest plot of comparison: 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, outcome: 1.1 Compliance: 1a. With medication ‐ non‐compliance.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ non‐compliance.
Figuras y tablas -
Analysis 1.1

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ non‐compliance.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 1b. With medication ‐ partial compliance.
Figuras y tablas -
Analysis 1.2

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 1b. With medication ‐ partial compliance.

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Study

Psychoed. mean

Psychoed. SD

Psychoed. N

Standard care mean

Standard care SD

Standard care N

single session ‐ average compliance with medication (SAI sub‐scale endpoint score, high = favourable)

Brief ‐ Individual 1996

2.6

1.2

22

2.1

1.3

20

three sessions ‐ average compliance with medication (SAI sub‐scale endpoint score, high = favourable)

Brief ‐ Individual 1996

2.18

1.3

22

2.1

1.3

20

Figuras y tablas -
Analysis 1.3

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 3 Compliance: 1c. With medication ‐ continuous outcomes ‐ skewed data.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 4 Compliance: 2a. With follow up ‐ loss to follow‐up for any reason.
Figuras y tablas -
Analysis 1.4

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 4 Compliance: 2a. With follow up ‐ loss to follow‐up for any reason.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 5 Compliance: 2b. With follow‐up ‐ received intervention but left the study early.
Figuras y tablas -
Analysis 1.5

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 5 Compliance: 2b. With follow‐up ‐ received intervention but left the study early.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 6 Compliance: 2c. With follow‐up ‐ allocated but never accepted treatment.
Figuras y tablas -
Analysis 1.6

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 6 Compliance: 2c. With follow‐up ‐ allocated but never accepted treatment.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 7 Relapse: 1. Relapse for any reason.
Figuras y tablas -
Analysis 1.7

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 7 Relapse: 1. Relapse for any reason.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 8 Relapse: 2. Relapse with readmission.
Figuras y tablas -
Analysis 1.8

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 8 Relapse: 2. Relapse with readmission.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 9 Knowledge: 1a. Average endpoint scale scores on various knowledge scales.
Figuras y tablas -
Analysis 1.9

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 9 Knowledge: 1a. Average endpoint scale scores on various knowledge scales.

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Study

Psychoed. mean

Psychoed. SD

Psychoed. N

Standard care mean

Standard care SD

Standard care N

single session psychoeducation

Brief ‐ Individual 1996

6.4

5.9

22

1.0

2.8

20

three session psychoeducation

Brief ‐ Individual 1996

15.00

7.4

22

1.0

2.8

20

Figuras y tablas -
Analysis 1.10

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 10 Knowledge: 1b. Average change (UMQ, high = favourable, data skewed).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 11 Knowledge: 2. Average endpoint scores on various insight scales.
Figuras y tablas -
Analysis 1.11

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 11 Knowledge: 2. Average endpoint scores on various insight scales.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 12 Knowledge: 3. Average endpoint score on illness‐related attitudes ‐ 4 months (KK, high = high expressed).
Figuras y tablas -
Analysis 1.12

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 12 Knowledge: 3. Average endpoint score on illness‐related attitudes ‐ 4 months (KK, high = high expressed).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 13 Knowledge: 4. level of knowledge did not improve.
Figuras y tablas -
Analysis 1.13

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 13 Knowledge: 4. level of knowledge did not improve.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 14 Behaviour: Average score (NOSIE‐30, endpoint, high = poor).
Figuras y tablas -
Analysis 1.14

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 14 Behaviour: Average score (NOSIE‐30, endpoint, high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 15 Social functioning: 1a. Average change scores on various scales ‐ medium term (high = poor).
Figuras y tablas -
Analysis 1.15

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 15 Social functioning: 1a. Average change scores on various scales ‐ medium term (high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 16 Social functioning: 1b. Average endpoint scores on various scales (high = poor).
Figuras y tablas -
Analysis 1.16

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 16 Social functioning: 1b. Average endpoint scores on various scales (high = poor).

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Study

Scale

Experimental N

Exp. mean + SD

Control N

Control mean + SD

Unclear ‐ Group 1996

Social Adjustment Scale II at end of study

52

2.40 + 1.30

62

2.60 + 1.30

Unclear ‐ Group 1996

Social Functioning Schedule score at 3 months

50

2.00 + 1.10

58

2.50 + 1.20

Unclear ‐ Group 1996

Total number of contacts (SNS, modified): post treatment

52

16.80 + 8.60

60

13.10 + 10.30

Unclear ‐ Group 1996

Total number of contacts (SNS, modified): at 3 months follow‐up

50

17.50 + 10.70

56

13.50 + 10.80

Figuras y tablas -
Analysis 1.17

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 17 Social functioning 1c. Average SAS, SFS, SNS scale scores ‐ skewed data (low = favourable).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 18 Global functioning: 1. No clinically significant improvement.
Figuras y tablas -
Analysis 1.18

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 18 Global functioning: 1. No clinically significant improvement.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 19 Global functioning: 2. Average endpoint scale score.
Figuras y tablas -
Analysis 1.19

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 19 Global functioning: 2. Average endpoint scale score.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 20 Service utilisation: days in hospital.
Figuras y tablas -
Analysis 1.20

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 20 Service utilisation: days in hospital.

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Study

Psychoed. mean

Psychoed. SD

Psychoed. N

Standard care mean

Standard care SD

Standard care N

Standard ‐ Both 1996

37.2

33.3

41

27.9

12.6

41

Figuras y tablas -
Analysis 1.21

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 21 Service utilisation: Days in hospital using 'acute services' ‐ during 18 months (data skewed).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 22 Global state: 1. Average endpoint score ‐ medium term (CGI, high = poor).
Figuras y tablas -
Analysis 1.22

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 22 Global state: 1. Average endpoint score ‐ medium term (CGI, high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 23 Global state: 2. Increased medication dose by 25%.
Figuras y tablas -
Analysis 1.23

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 23 Global state: 2. Increased medication dose by 25%.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 24 Global state: 3. Disability ‐ long term.
Figuras y tablas -
Analysis 1.24

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 24 Global state: 3. Disability ‐ long term.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 25 Mental state: 1a. Global ‐ continuous ‐ average total endpoint scale scores (high = poor).
Figuras y tablas -
Analysis 1.25

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 25 Mental state: 1a. Global ‐ continuous ‐ average total endpoint scale scores (high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 26 Mental state: 1b. Global ‐ continuous ‐ average change scale scores ‐ medium term (high = good).
Figuras y tablas -
Analysis 1.26

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 26 Mental state: 1b. Global ‐ continuous ‐ average change scale scores ‐ medium term (high = good).

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Study

Length of follow‐up

Psychoed. N

Exp. mean + SD

Control N

Control mean + SD

Brief ‐ Group 1999

at end of study (8 weeks)

22

11.41±7.91

19

13.50±9.54

Brief ‐ Group 1999

at 1 year

22

8.86±6.19

18

10.50±7.37

Brief ‐ Group 2009

at end of study (3 months)

36

5.69±7.91

37

8.81±9.58

Brief ‐ Group 2009

at 1 year

36

4.5±5.11

37

8.81±9.12

Figuras y tablas -
Analysis 1.27

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 27 Mental state: 1c. Global ‐ continuous ‐ average total endpoint scale scores ‐ (BPRS, high = poor, data skewed).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 28 Mental state: 2a. Specific ‐ binary ‐ specific symptoms ‐ short term.
Figuras y tablas -
Analysis 1.28

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 28 Mental state: 2a. Specific ‐ binary ‐ specific symptoms ‐ short term.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 29 Mental state: 2b. Specific ‐ continuous ‐ average endpoint PANSS scores (high = poor).
Figuras y tablas -
Analysis 1.29

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 29 Mental state: 2b. Specific ‐ continuous ‐ average endpoint PANSS scores (high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 30 Expressed emotion: Participants with high EE relatives (FQ).
Figuras y tablas -
Analysis 1.30

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 30 Expressed emotion: Participants with high EE relatives (FQ).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 31 Quality of life: Average endpoint scores on various scales (high = favourable).
Figuras y tablas -
Analysis 1.31

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 31 Quality of life: Average endpoint scores on various scales (high = favourable).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 32 Quality of life: Average endpoint scores on various scales (high = poor).
Figuras y tablas -
Analysis 1.32

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 32 Quality of life: Average endpoint scores on various scales (high = poor).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 33 Satisfaction with mental health services: 1. Short term ‐ average change score (VSS, high = good).
Figuras y tablas -
Analysis 1.33

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 33 Satisfaction with mental health services: 1. Short term ‐ average change score (VSS, high = good).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 34 Satisfaction with mental health services: 2. Average change ‐ at 1 year (VSS Scale, high = good).
Figuras y tablas -
Analysis 1.34

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 34 Satisfaction with mental health services: 2. Average change ‐ at 1 year (VSS Scale, high = good).

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 35 Satisfaction with mental health services: 3. Binary outcome.
Figuras y tablas -
Analysis 1.35

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 35 Satisfaction with mental health services: 3. Binary outcome.

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Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 36 Adverse event: Death.
Figuras y tablas -
Analysis 1.36

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 36 Adverse event: Death.

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Study

Psychoed. mean

Psychoed. SD

Psychoed. N

Standard care mean

Standard care SD

Standard care N

acute hospital charges

Standard ‐ Both 1996

6537

17248.0

41

7863

12038

41

ambulatory charges

Standard ‐ Both 1996

6488

4332.8

41

5212

3500.1

41

total charges

Standard ‐ Both 1996

13025

16358.4

41

13075

12000

41

Figuras y tablas -
Analysis 1.37

Comparison 1 ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE, Outcome 37 Economic outcomes: Costs (US$ per person, data skewed).

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Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ binary outcomes.
Figuras y tablas -
Analysis 2.1

Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ binary outcomes.

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Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 2. With follow‐up ‐ loss to follow‐up for any reason.
Figuras y tablas -
Analysis 2.2

Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 2. With follow‐up ‐ loss to follow‐up for any reason.

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Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 3 Compliance: 2a. with follow‐up ‐ received intervention but left the study early.
Figuras y tablas -
Analysis 2.3

Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 3 Compliance: 2a. with follow‐up ‐ received intervention but left the study early.

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Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 4 Relapse: Relapse for any reason.
Figuras y tablas -
Analysis 2.4

Comparison 2 SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE, Outcome 4 Relapse: Relapse for any reason.

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Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ binary outcomes.
Figuras y tablas -
Analysis 3.1

Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 1 Compliance: 1a. With medication ‐ binary outcomes.

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Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 2. With follow‐up ‐ leaving the study early/loss to follow‐up.
Figuras y tablas -
Analysis 3.2

Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 2 Compliance: 2. With follow‐up ‐ leaving the study early/loss to follow‐up.

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Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 3 Relapse: Relapse for any reason.
Figuras y tablas -
Analysis 3.3

Comparison 3 SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE, Outcome 3 Relapse: Relapse for any reason.

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Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 1 Compliance: 1a. With medication ‐ non‐compliance.
Figuras y tablas -
Analysis 4.1

Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 1 Compliance: 1a. With medication ‐ non‐compliance.

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Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 2 Compliance: 2a. With follow‐up ‐ loss to follow‐up for any reason.
Figuras y tablas -
Analysis 4.2

Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 2 Compliance: 2a. With follow‐up ‐ loss to follow‐up for any reason.

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Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 3 Compliance: 2b. With follow‐up ‐ received intervention but left the study early.
Figuras y tablas -
Analysis 4.3

Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 3 Compliance: 2b. With follow‐up ‐ received intervention but left the study early.

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Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 4 Relapse: 1. Relapse for any reason.
Figuras y tablas -
Analysis 4.4

Comparison 4 SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies, Outcome 4 Relapse: 1. Relapse for any reason.

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Table 3. Suggested design of study

Methods

Allocation: randomised, fully explicit description of methods of randomisation and allocation concealment.
Blinding: single, tested.
Setting: community rather than hospital.
Duration: 12 weeks treatment, and then follow‐up to at least 52 weeks.

Participants

Diagnosis: schizophrenia (ICD).
N = 300.*
Age: adults.
Sex: both.

Interventions

1. Psychoeducation. N = 150.

2. Standard care. N = 150.

Outcomes

General: time to all‐cause treatment failure marked by its discontinuation, relapse, general impression of clinician (CGI), career/other, compliance with treatment, healthy days.
Mental state: BPRS and PANSS.
Global state: CGI (Clinical Global Impression).
Quality of life. QOL (Quality of Life Questionnaire).
Family burden: FBQ (Family Burden Questionnaire).
Social functioning: return to everyday living for 80% of time.*
Adverse events: any adverse event recorded.
Economic outcomes.

Notes

* Powered to be able to identify a difference of ˜ 20% between groups for primary outcome with adequate degree of certainty.

Figuras y tablas -
Table 3. Suggested design of study
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Summary of findings for the main comparison. ANY FORM OF PSYCHOEDUCATION compared with STANDARD CARE for schizophrenia

ANY FORM OF PSYCHOEDUCATION compared with STANDARD CARE for schizophrenia

Patient or population: patients with schizophrenia
Settings: in hospital
Intervention: ANY FORM OF PSYCHOEDUCATION
Comparison: STANDARD CARE

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

STANDARD CARE

ANY FORM OF PSYCHOEDUCATION

Compliance: Not compliant with medication
Follow‐up: 12 months

Low risk population1

RR 0.48
(0.31 to 0.75)

282
(3 studies)

⊕⊝⊝⊝
very low2,3,4

200 per 1000

96 per 1000
(62 to 150)

Medium risk population1

400 per 1000

192 per 1000
(124 to 300)

High risk population1

800 per 1000

384 per 1000
(248 to 600)

Compliance: 2a. With follow‐up ‐ loss to follow‐up for any reason ‐ long term (by 5 years or more)
Follow‐up: 12 months

Low risk population1

RR 0.77
(0.48 to 1.23)

172
(2 studies)

⊕⊝⊝⊝
very low2,3,4

200 per 1000

154 per 1000
(96 to 246)

Medium risk population1

400 per 1000

308 per 1000
(192 to 492)

High risk population1

800 per 1000

616 per 1000
(384 to 984)

Compliance: 2b. With follow‐up ‐ received intervention but left the study early ‐ long term
Follow‐up: 12 months

Low risk population1

RR 0.63
(0.38 to 1.04)

206
(2 studies)

⊕⊕⊝⊝
low2,4

200 per 1000

126 per 1000
(76 to 208)

Medium risk population1

400 per 1000

252 per 1000
(152 to 416)

High risk population1

800 per 1000

504 per 1000
(304 to 832)

Relapse: 1. Relapse for any reason ‐ long term
Follow‐up: 12 months

Low risk population5

RR 0.73
(0.62 to 0.85)

790
(6 studies)

⊕⊕⊝⊝
low4,6

200 per 1000

146 per 1000
(124 to 170)

Medium risk population5

400 per 1000

292 per 1000
(248 to 340)

High risk population5

800 per 1000

584 per 1000
(496 to 680)

Relapse: 2. Relapse with readmission ‐ long term
Follow‐up: 12 months

Low risk population7

RR 0.71
(0.56 to 0.89)

206
(2 studies)

⊕⊕⊝⊝
low2,4

200 per 1000

142 per 1000
(112 to 178)

Medium risk population7

400 per 1000

284 per 1000
(224 to 356)

High risk population7

800 per 1000

568 per 1000
(448 to 712)

Satisfaction with mental health services: 3. binary outcome ‐ medium term ‐ unsatisfied
Follow‐up: 12 months

Low risk population1

RR 0.4
(0.17 to 0.96)

116
(1 study)

⊕⊕⊝⊝
low2,4

200 per 1000

80 per 1000
(34 to 192)

Medium risk population1

400 per 1000

160 per 1000
(68 to 384)

High risk population1

800 per 1000

320 per 1000
(136 to 768)

Adverse event: Death ‐ long term
Follow‐up: 12 months

Low risk population8

RR 1.39
(0.24 to 8.11)

344
(2 studies)

⊕⊕⊝⊝
low2,4

10 per 1000

14 per 1000
(2 to 81)

Medium risk population8

30 per 1000

42 per 1000
(7 to 243)

High risk population8

50 per 1000

69 per 1000
(12 to 405)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Control risk from studies ‐ about 30%
2 Randomisation poorly described
3 High heterogeneity not explained by study design, population or interventions
4 Small sample size ‐ confidence interval around best estimate of effect include both no effect and appreciable benefit/harm
5 Control risk from studies ‐ about 50%
6 50% of the included studies used scientific randomisation methods and provided description of methods, but the other 50% did not describe randomisation methods
7 Control risk from studies ‐ about 70%
8 Control risk from studies ‐ about 1%

Figuras y tablas -
Summary of findings for the main comparison. ANY FORM OF PSYCHOEDUCATION compared with STANDARD CARE for schizophrenia
Ir a la tabla de la revisión
Table 1. Chinese studies vs full analysis (sensitivity analyses)

Primary outcome

China
Experimental

China
Control

China
RR (CI)

Full analysis
Experimental

Full analysis
Control

Full analysis
RR (CI)

Compliance

19/174

22/172

0.85 (0.48‐1.51)

109/488

101/461

1.00 (0.79‐1.26)

Relapse

44/353

90/347

0.48 (0.35‐0.66)

174/628

22/586

0.7 (0.61‐0.81)
Figuras y tablas -
Table 1. Chinese studies vs full analysis (sensitivity analyses)
Ir a la tabla de la revisión
Table 2. English studies vs full analysis (sensitivity analyses)

Primary outcome

English
Experimental

English
Control

English
RR (CI)

Full analysis
Experimental

Full analysis
Control

Full analysis
RR (CI)

Compliance

90/314

79/289

1.04 (0.8‐1.34)

109/488

101/461

1.00 (0.79‐1.26)

Relapse

130/275

132/239

0.85 (0.73‐0.99)

174/628

22/586

0.7 (0.61‐0.81)
Figuras y tablas -
Table 2. English studies vs full analysis (sensitivity analyses)
Ir a la tabla de la revisión
Comparison 1. ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Compliance: 1a. With medication ‐ non‐compliance Show forest plot

18

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 short term

10

1400

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.40, 0.67]

1.2 medium term

6

781

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.27, 0.49]

1.3 long term

3

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.75]

2 Compliance: 1b. With medication ‐ partial compliance Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 short term

3

472

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.49, 0.85]

2.2 medium term

1

118

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.39, 1.18]

3 Compliance: 1c. With medication ‐ continuous outcomes ‐ skewed data Show forest plot

Other data

No numeric data

3.1 single session ‐ average compliance with medication (SAI sub‐scale endpoint score, high = favourable)

Other data

No numeric data

3.2 three sessions ‐ average compliance with medication (SAI sub‐scale endpoint score, high = favourable)

Other data

No numeric data

4 Compliance: 2a. With follow up ‐ loss to follow‐up for any reason Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 medium term ‐ loss to follow‐up for any reason

8

949

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.79, 1.26]

4.2 long term ‐ loss to follow‐up for any reason (by 2 years)

3

420

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.62, 1.10]

4.3 long term ‐ loss to follow‐up for any reason (by 5 years or more)

2

172

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.48, 1.23]

5 Compliance: 2b. With follow‐up ‐ received intervention but left the study early Show forest plot

7

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 short term

2

87

Risk Ratio (M‐H, Fixed, 95% CI)

3.04 [0.36, 25.67]

5.2 medium term

4

319

Risk Ratio (M‐H, Fixed, 95% CI)

0.56 [0.29, 1.10]

5.3 long term

2

206

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.38, 1.04]

6 Compliance: 2c. With follow‐up ‐ allocated but never accepted treatment Show forest plot

2

213

Risk Ratio (M‐H, Fixed, 95% CI)

12.27 [2.58, 58.33]

6.1 medium term

2

213

Risk Ratio (M‐H, Fixed, 95% CI)

12.27 [2.58, 58.33]

7 Relapse: 1. Relapse for any reason Show forest plot

16

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 medium term

11

1214

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.61, 0.81]

7.2 long term

6

790

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.62, 0.85]

7.3 long term (at 5 years follow‐up)

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.73, 1.08]

7.4 long term (at 7 years follow‐up)

1

48

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.42, 0.92]

8 Relapse: 2. Relapse with readmission Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 medium term

2

206

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.56, 1.07]

8.2 long term

2

206

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.56, 0.89]

9 Knowledge: 1a. Average endpoint scale scores on various knowledge scales Show forest plot

6

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 short term ‐ at end of intervention (KQ, high = favourable)

1

75

Mean Difference (IV, Fixed, 95% CI)

‐10.00 [‐17.67, ‐6.33]

9.2 short term (KASQ, high = favourable)

1

71

Mean Difference (IV, Fixed, 95% CI)

0.20 [‐2.12, 2.52]

9.3 short term (ITAQ, high = favourable)

3

295

Mean Difference (IV, Fixed, 95% CI)

5.53 [4.56, 6.49]

9.4 short term (SKQ, high = favourable)

1

19

Mean Difference (IV, Fixed, 95% CI)

‐16.26 [‐22.72, ‐9.80]

9.5 medium term (ITAQ, high = favourable)

1

73

Mean Difference (IV, Fixed, 95% CI)

4.83 [1.51, 8.15]

9.6 medium term (KASQ, high = favourable)

1

61

Mean Difference (IV, Fixed, 95% CI)

1.60 [‐0.84, 4.04]

9.7 long term (KQ, high = favourable)

1

75

Mean Difference (IV, Fixed, 95% CI)

‐8.0 [‐14.64, ‐1.36]

10 Knowledge: 1b. Average change (UMQ, high = favourable, data skewed) Show forest plot

Other data

No numeric data

10.1 single session psychoeducation

Other data

No numeric data

10.2 three session psychoeducation

Other data

No numeric data

11 Knowledge: 2. Average endpoint scores on various insight scales Show forest plot

3

217

Mean Difference (IV, Fixed, 95% CI)

‐0.19 [‐1.31, 0.93]

11.1 short term (SAUMD, high = poor)

2

161

Mean Difference (IV, Fixed, 95% CI)

‐0.63 [‐1.86, 0.61]

11.2 medium term (RAQ, high = poor)

1

56

Mean Difference (IV, Fixed, 95% CI)

1.80 [‐0.85, 4.45]

12 Knowledge: 3. Average endpoint score on illness‐related attitudes ‐ 4 months (KK, high = high expressed) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

12.1 confidence in medication

1

75

Mean Difference (IV, Fixed, 95% CI)

‐1.5 [‐3.21, 0.21]

12.2 confidence in physician

1

75

Mean Difference (IV, Fixed, 95% CI)

‐1.40 [‐2.73, ‐0.07]

12.3 negative expectations toward medication as such

1

75

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.07, 1.07]

12.4 susceptibility to illness and to relapse

1

75

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐0.78, 1.98]

12.5 attribution of illness to chance

1

75

Mean Difference (IV, Fixed, 95% CI)

‐0.70 [‐2.30, 0.90]

12.6 attribution of guilt

1

75

Mean Difference (IV, Fixed, 95% CI)

‐0.80 [‐2.07, 0.47]

12.7 fear of side effects of medication

1

75

Mean Difference (IV, Fixed, 95% CI)

‐1.60 [‐2.74, ‐0.46]

13 Knowledge: 4. level of knowledge did not improve Show forest plot

2

216

Risk Ratio (M‐H, Fixed, 95% CI)

0.13 [0.06, 0.28]

14 Behaviour: Average score (NOSIE‐30, endpoint, high = poor) Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

14.1 short term

2

202

Mean Difference (IV, Fixed, 95% CI)

16.85 [11.90, 21.80]

14.2 medium term

1

73

Mean Difference (IV, Fixed, 95% CI)

14.0 [3.03, 24.97]

14.3 long term

1

70

Mean Difference (IV, Fixed, 95% CI)

41.33 [31.02, 51.64]

15 Social functioning: 1a. Average change scores on various scales ‐ medium term (high = poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

15.1 MRSS

1

118

Mean Difference (IV, Fixed, 95% CI)

13.68 [12.51, 14.85]

15.2 SDSS

1

118

Mean Difference (IV, Fixed, 95% CI)

1.96 [1.83, 2.09]

16 Social functioning: 1b. Average endpoint scores on various scales (high = poor) Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

16.1 short term ‐ IPROS

1

116

Mean Difference (IV, Fixed, 95% CI)

‐6.64 [‐11.02, ‐2.26]

16.2 short term ‐ SAS

3

378

Mean Difference (IV, Fixed, 95% CI)

‐8.53 [‐10.50, ‐6.55]

16.3 short term ‐ SAS‐II

1

19

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.37, 0.17]

16.4 short term ‐ SDS

3

378

Mean Difference (IV, Fixed, 95% CI)

‐5.60 [‐7.55, ‐3.65]

16.5 medium term ‐ SDSS

1

85

Mean Difference (IV, Fixed, 95% CI)

‐3.74 [‐6.05, ‐1.43]

17 Social functioning 1c. Average SAS, SFS, SNS scale scores ‐ skewed data (low = favourable) Show forest plot

Other data

No numeric data

18 Global functioning: 1. No clinically significant improvement Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

18.1 short term

2

208

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.32, 1.13]

18.2 medium term

2

178

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.43, 0.82]

18.3 long term

2

132

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.48, 1.04]

19 Global functioning: 2. Average endpoint scale score Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

19.1 short term ‐ (GAF/GAS, high = good)

1

41

Mean Difference (IV, Fixed, 95% CI)

‐2.64 [‐12.74, 7.46]

19.2 short term ‐ (SLOF, high = good)

1

84

Mean Difference (IV, Fixed, 95% CI)

23.60 [11.88, 35.32]

19.3 medium term ‐ (GAF/GAS, high = good)

4

321

Mean Difference (IV, Fixed, 95% CI)

‐5.44 [‐8.51, ‐2.38]

19.4 medium term ‐ (SLOF, high = good)

1

84

Mean Difference (IV, Fixed, 95% CI)

46.40 [34.45, 58.35]

19.5 long term (GAS, high = good) ‐ at 2 years

1

59

Mean Difference (IV, Fixed, 95% CI)

‐6.70 [‐13.38, ‐0.02]

19.6 long term ‐ (GAS, high = good) ‐ at 5 years or more

2

108

Mean Difference (IV, Fixed, 95% CI)

‐3.36 [‐7.24, 0.52]

20 Service utilisation: days in hospital Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

20.1 short term ‐ days in hospital

2

200

Mean Difference (IV, Fixed, 95% CI)

‐3.23 [‐5.44, ‐1.01]

20.2 medium term ‐ days in hospital

1

84

Mean Difference (IV, Fixed, 95% CI)

‐8.4 [‐10.44, ‐6.36]

21 Service utilisation: Days in hospital using 'acute services' ‐ during 18 months (data skewed) Show forest plot

Other data

No numeric data

22 Global state: 1. Average endpoint score ‐ medium term (CGI, high = poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

22.1 severity

1

61

Mean Difference (IV, Fixed, 95% CI)

0.50 [0.08, 0.92]

22.2 change

1

61

Mean Difference (IV, Fixed, 95% CI)

‐0.80 [‐1.45, ‐0.15]

23 Global state: 2. Increased medication dose by 25% Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.43 [0.15, 1.20]

24 Global state: 3. Disability ‐ long term Show forest plot

1

86

Risk Ratio (M‐H, Fixed, 95% CI)

0.29 [0.13, 0.64]

25 Mental state: 1a. Global ‐ continuous ‐ average total endpoint scale scores (high = poor) Show forest plot

17

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

25.1 short term (BPRS)

11

1107

Mean Difference (IV, Fixed, 95% CI)

‐1.00 [‐1.38, ‐0.63]

25.2 medium term (BPRS)

7

760

Mean Difference (IV, Fixed, 95% CI)

‐4.73 [‐5.55, ‐3.91]

25.3 medium term (PANSS)

2

163

Mean Difference (IV, Fixed, 95% CI)

‐2.52 [‐5.01, ‐0.04]

25.4 long term (BPRS ‐ 1 ˜ 2 year follow‐up)

3

370

Mean Difference (IV, Fixed, 95% CI)

‐6.89 [‐8.55, ‐5.23]

25.5 long term (BPRS ‐ 7 year follow‐up)

1

48

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐6.55, 6.15]

26 Mental state: 1b. Global ‐ continuous ‐ average change scale scores ‐ medium term (high = good) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

26.1 GWB

1

118

Mean Difference (IV, Fixed, 95% CI)

10.89 [9.82, 11.96]

26.2 SES

1

118

Mean Difference (IV, Fixed, 95% CI)

8.00 [7.77, 8.23]

27 Mental state: 1c. Global ‐ continuous ‐ average total endpoint scale scores ‐ (BPRS, high = poor, data skewed) Show forest plot

Other data

No numeric data

28 Mental state: 2a. Specific ‐ binary ‐ specific symptoms ‐ short term Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

28.1 anxiety

1

146

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.25, 0.93]

28.2 depression

1

146

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.25, 0.88]

29 Mental state: 2b. Specific ‐ continuous ‐ average endpoint PANSS scores (high = poor) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

29.1 short term ‐ negative symptoms

1

71

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐1.98, 2.78]

29.2 short term ‐ positive symptoms

1

71

Mean Difference (IV, Fixed, 95% CI)

1.5 [‐0.99, 3.99]

29.3 medium term ‐ negative symptoms

1

61

Mean Difference (IV, Fixed, 95% CI)

3.1 [0.16, 6.04]

29.4 medium term ‐ positive symptoms

1

61

Mean Difference (IV, Fixed, 95% CI)

2.40 [‐0.46, 5.26]

30 Expressed emotion: Participants with high EE relatives (FQ) Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

30.1 short term ‐ at end of interventions

2

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.76, 0.94]

30.2 medium term ‐ at 9‐12 months

1

46

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.64, 1.78]

31 Quality of life: Average endpoint scores on various scales (high = favourable) Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

31.1 short term ‐ GQOLI‐74

1

62

Mean Difference (IV, Fixed, 95% CI)

0.63 [‐0.79, 2.05]

31.2 short term ‐ PGWB

1

71

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐6.08, 10.08]

31.3 medium term ‐ GQOLI‐74

1

62

Mean Difference (IV, Fixed, 95% CI)

2.13 [1.03, 3.23]

31.4 medium term ‐ QOL

1

108

Mean Difference (IV, Fixed, 95% CI)

‐9.70 [‐17.22, ‐2.18]

31.5 medium term ‐ PGWB

1

61

Mean Difference (IV, Fixed, 95% CI)

2.80 [‐5.40, 11.00]

32 Quality of life: Average endpoint scores on various scales (high = poor) Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

32.1 short term ‐ FAD

1

62

Mean Difference (IV, Fixed, 95% CI)

‐0.42 [‐5.45, 4.61]

32.2 short term ‐ FBIS

1

84

Mean Difference (IV, Fixed, 95% CI)

‐4.70 [‐7.19, ‐2.21]

32.3 medium term ‐ FAD

1

62

Mean Difference (IV, Fixed, 95% CI)

‐6.79 [‐11.67, ‐1.91]

32.4 medium term ‐ FBIS

2

241

Mean Difference (IV, Fixed, 95% CI)

‐6.24 [‐7.80, ‐4.68]

33 Satisfaction with mental health services: 1. Short term ‐ average change score (VSS, high = good) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

33.1 patients' satisfaction

1

32

Mean Difference (IV, Fixed, 95% CI)

‐2.15 [‐13.96, 9.66]

33.2 relatives' satisfaction

1

17

Mean Difference (IV, Fixed, 95% CI)

‐8.31 [‐29.72, 13.10]

34 Satisfaction with mental health services: 2. Average change ‐ at 1 year (VSS Scale, high = good) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

34.1 patients' satisfaction with relatives' involvement ‐ mean change

1

30

Mean Difference (IV, Fixed, 95% CI)

‐4.35 [‐7.09, ‐1.61]

34.2 relatives' involvement satisfaction

1

21

Mean Difference (IV, Fixed, 95% CI)

‐2.17 [‐6.11, 1.77]

34.3 relatives' efficacy satisfaction

1

24

Mean Difference (IV, Fixed, 95% CI)

‐2.16 [‐7.29, 2.97]

34.4 relatives' intervention satisfaction

1

26

Mean Difference (IV, Fixed, 95% CI)

‐3.43 [‐9.83, 2.97]

35 Satisfaction with mental health services: 3. Binary outcome Show forest plot

2

236

Risk Ratio (M‐H, Fixed, 95% CI)

0.24 [0.12, 0.50]

35.1 short term ‐ unsatisfied

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

0.11 [0.03, 0.46]

35.2 medium term ‐ unsatisfied

1

116

Risk Ratio (M‐H, Fixed, 95% CI)

0.4 [0.17, 0.96]

36 Adverse event: Death Show forest plot

4

626

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.31, 4.21]

36.1 medium term

2

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.13, 6.35]

36.2 long term

2

344

Risk Ratio (M‐H, Fixed, 95% CI)

1.39 [0.24, 8.11]

37 Economic outcomes: Costs (US$ per person, data skewed) Show forest plot

Other data

No numeric data

37.1 acute hospital charges

Other data

No numeric data

37.2 ambulatory charges

Other data

No numeric data

37.3 total charges

Other data

No numeric data
Figuras y tablas -
Comparison 1. ANY FORM OF PSYCHOEDUCATION vs STANDARD CARE
Ir a la tabla de la revisión
Comparison 2. SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Compliance: 1a. With medication ‐ binary outcomes Show forest plot

12

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 short term ‐ non‐compliance ‐ brief

3

448

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.41, 0.96]

1.2 short term ‐ non‐compliance ‐ standard

4

586

Risk Ratio (M‐H, Fixed, 95% CI)

0.41 [0.25, 0.67]

1.3 medium term ‐ non‐compliance ‐ brief

1

118

Risk Ratio (M‐H, Fixed, 95% CI)

0.17 [0.05, 0.54]

1.4 medium term ‐ non‐compliance ‐ standard

4

561

Risk Ratio (M‐H, Fixed, 95% CI)

0.44 [0.32, 0.62]

2 Compliance: 2. With follow‐up ‐ loss to follow‐up for any reason Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 medium term ‐ brief

2

170

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.37, 0.94]

2.2 medium term ‐ standard

7

739

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.83, 1.55]

2.3 long term (by 2 years) ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.43, 1.15]

2.4 long term (by 2 years) ‐ standard

1

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.66, 1.42]

2.5 long term (by 5 years or more) ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.44, 1.21]

2.6 long term (by 5 years or more) ‐ standard

1

48

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.28, 3.54]

3 Compliance: 2a. with follow‐up ‐ received intervention but left the study early Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 short term ‐ brief

1

67

Risk Ratio (M‐H, Fixed, 95% CI)

3.06 [0.17, 56.70]

3.2 short term ‐ standard

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.14, 65.90]

3.3 long term ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.58 [0.33, 1.01]

3.4 long term ‐ standard

1

82

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.28, 2.52]

4 Relapse: Relapse for any reason Show forest plot

14

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 relapse ‐ medium term ‐ brief

3

292

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.43, 0.89]

4.2 relapse ‐ medium term ‐ standard

6

1011

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.77, 0.99]

4.3 relapse with readmission ‐ medium term ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.59, 1.22]

4.4 relapse with readmission ‐ medium term ‐ standard

1

82

Risk Ratio (M‐H, Fixed, 95% CI)

0.6 [0.30, 1.21]

4.5 relapse ‐ long term ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.59, 1.22]

4.6 relapse ‐ long term ‐ standard

5

666

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.59, 0.84]

4.7 relapse with readmission ‐ long term ‐ brief

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.64, 1.08]

4.8 relapse with readmission ‐ long term ‐ standard

1

82

Risk Ratio (M‐H, Fixed, 95% CI)

0.53 [0.35, 0.82]
Figuras y tablas -
Comparison 2. SUBGROUP ANALYSES 1. BRIEF PSYCHOEDUCATION/STANDARD PSYCHOEDUCATION vs STANDARD CARE
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Comparison 3. SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Compliance: 1a. With medication ‐ binary outcomes Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 short term ‐ non‐compliance ‐ group

3

412

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.13, 0.52]

1.2 short term ‐ non‐compliance ‐ individual

2

296

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.39, 1.11]

1.3 short term ‐ partial compliance ‐ group

1

250

Risk Ratio (M‐H, Fixed, 95% CI)

0.76 [0.50, 1.16]

1.4 short term ‐ partial compliance ‐ individual

1

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.41, 0.92]

2 Compliance: 2. With follow‐up ‐ leaving the study early/loss to follow‐up Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 medium term ‐ received intervention but left the study early ‐ group

2

213

Risk Ratio (M‐H, Fixed, 95% CI)

0.52 [0.25, 1.06]

2.2 medium term ‐ received intervention but left the study early ‐ individual

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.14, 65.90]

2.3 medium term ‐ loss to follow‐up for any reason ‐ group

4

367

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.61, 1.20]

2.4 medium term ‐ loss to follow‐up for any reason ‐ individual

1

73

Risk Ratio (M‐H, Fixed, 95% CI)

1.95 [0.18, 20.53]

2.5 long term ‐ loss to follow‐up for any reason (by 2 years) ‐ group

1

124

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.43, 1.15]

2.6 long term ‐ loss to follow‐up for any reason (by 2 years) ‐ individual

2

296

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.63, 1.29]

3 Relapse: Relapse for any reason Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 relapse ‐ medium term ‐ group

4

410

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.57, 0.96]

3.2 relapse ‐ medium term ‐ individual

1

73

Risk Ratio (M‐H, Fixed, 95% CI)

0.45 [0.19, 1.05]

3.3 relapse ‐ long term ‐ group

2

344

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.66, 0.99]

3.4 relapse ‐ long term ‐ individual

1

136

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.57, 0.94]
Figuras y tablas -
Comparison 3. SUBGROUP ANALYSES 2. GROUP PSYCHOEDUCATION/INDIVIDUAL PSYCHOEDUCATION vs STANDARD CARE
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Comparison 4. SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Compliance: 1a. With medication ‐ non‐compliance Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 long term

3

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.75]

1.2 long term ‐ Chinese studies

3

282

Risk Ratio (M‐H, Fixed, 95% CI)

0.48 [0.31, 0.75]

2 Compliance: 2a. With follow‐up ‐ loss to follow‐up for any reason Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 medium term ‐ loss to follow‐up for any reason

8

949

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.79, 1.26]

2.2 medium term ‐ loss to follow‐up for any reason ‐ Chinese studies

8

949

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.79, 1.26]

2.3 long term ‐ loss to follow‐up for any reason (by 2 years)

3

420

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.62, 1.10]

2.4 long term ‐ loss to follow‐up for any reason (by 2 years) ‐ Chinese studies

3

420

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.62, 1.10]

3 Compliance: 2b. With follow‐up ‐ received intervention but left the study early Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 medium term

4

319

Risk Ratio (M‐H, Fixed, 95% CI)

0.56 [0.29, 1.10]

3.2 medium term ‐ Chinese studies

4

319

Risk Ratio (M‐H, Fixed, 95% CI)

0.56 [0.29, 1.10]

4 Relapse: 1. Relapse for any reason Show forest plot

16

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 medium term

11

1214

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.61, 0.81]

4.2 medium term ‐ Chinese studies

11

1214

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.61, 0.81]

4.3 long term

6

790

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.62, 0.85]

4.4 long term ‐ Chinese studies

6

790

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.62, 0.85]
Figuras y tablas -
Comparison 4. SENSITIVITY ANALYSIS ‐ Chinese studies vs non‐Chinese studies
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