Psychosocial interventions for people with both severe mental
illness and substance misuse
Glenn E Hunt1, Nandi Siegfried2, Kirsten Morley3, Thiagarajan Sitharthan1, Michelle
Cleary4 1Discipline of Psychiatry, The University of Sydney, Sydney, Australia.
2Department of Psychiatry and Mental Health, University of Cape Town, Cape Town,
South Africa. 3Addiction Medicine, The University of Sydney, Sydney, Australia.
4School of Nursing and Midwifery, University of Western Sydney,
NSW, Australia Contact address: Glenn E Hunt, Discipline of Psychiatry,
The University of Sydney, Concord Centrefor Mental Health, Hospital Road,
Sydney, NSW, 2139, Australia. glenn.hunt@sydney.edu.au.
Editorial group: Cochrane Schizophrenia Group.
Publication status and date: Edited (no change to conclusions), published in Issue 4, 2014.
Review content assessed as up-to-date: 15 January 2013.
Citation: Hunt GE, Siegfried N, Morley K, Sitharthan T, Cleary M. Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD001088. DOI: 10.1002/14651858.CD001088.pub3.
Copyright © 2014 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.
A B S T R A C T
Background
Even low levels of substance misuse by people with a severe mental illness can have detrimental effects.
Objectives
To assess the effects of psychosocial interventions for reduction in substance use in people with a serious mental illness compared with standard care.
Search methods
For this update (2013), the Trials Search Co-ordinator of the Cochrane Schizophrenia Group (CSG) searched the CSG Trials Register (July 2012), which is based on regular searches of major medical and scientific databases. The principal authors conducted two further searches (8 October 2012 and 15 January 2013) of the Cochrane Database of Systematic Reviews, MEDLINE and PsycINFO. A separate search for trials of contingency management was completed as this was an additional intervention category for this update.
Selection criteria
We included all randomised controlled trials (RCTs) comparing psychosocial interventions for substance misuse with standard care in people with serious mental illness.
Data collection and analysis
We independently selected studies, extracted data and appraised study quality. For binary outcomes, we calculated standard estimates of relative risk (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis. For continuous outcomes, we calculated the mean difference (MD) between groups. For all meta-analyses we pooled data using a random-effects model. Using the GRADE approach, we identified seven patient-centred outcomes and assessed the quality of evidence for these within each comparison.