search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects
Pfammatter, M., Junghan, U. M. & Brenner, H. D. (2006). Schizophrenia Bulletin, 32(Suppl1). S64-S80.
Over the past years, evidence for the efficacy of psychological therapies in schizophrenia has been summarized in a series of meta-analyses. The present contribution aims to provide a descriptive survey of the evidence for the efficacy of psychological therapies as derived from these meta-analyses and to supplement them by selected findings from an own recent meta-analysis. Relevant meta-analyses and randomized controlled trials were identified by searching several electronic databases and by hand searching of reference lists. In order to compare the findings of the existing meta-analyses, the reported effect sizes were extracted and transformed into a uniform effect size measure where possible. For the own meta-analysis, weighted mean effect size differences between comparison groups regarding various types of outcomes were estimated. Their significance was tested by confidence intervals, and heterogeneity tests were applied to examine the consistency of the effects. From the available meta-analyses, social skills training, cognitive remediation, psychoeducational coping-oriented interventions with families and relatives, as well as cognitive behavioral therapy of persistent positive symptoms emerge as effective adjuncts to pharmacotherapy. Social skills training consistently effectuates the acquisition of social skills, cognitive remediation leads to short-term improvements in cognitive functioning, family interventions decrease relapse and hospitalization rates, and cognitive behavioral therapy results in a reduction of positive symptoms. These benefits seem to be accompanied by slight improvements in social functioning. However, open questions remain as to the specific therapeutic ingredients, to the synergistic effects, to the indication, as well as to the generalizability of the findings to routine care.
Scott, J. (2006). Journal of Psychopharmacology, 20(2,Suppl), 46-50.
This paper explores the development of psychological treatments as an adjunct to medication in bipolar disorders. Randomized controlled treatment trials of specific therapy models, such as cognitive therapy, that tackle a spectrum of complex psychological and social problems associated with bipolar disorders are reviewed. A systematic review of the most recent treatment outcome studies suggest that adjunctive psychological therapies reduce overall rates of relapse, but are more effective for depression than for mania. There is no evidence that any particular therapy has a unique mechanism of action or any specific advantages over any other approach. Finally, it is suggested that gaps in the theory and available evidence for effectiveness need to be addressed if we are to enable clinicians to target psychological therapies towards those individuals with bipolar disorder who are most likely to benefi