Psychological interventions for treatment of XXXX .

@entity1 @entity308 @entity8461 @entity29
BACKGROUND: The effect of psychological interventions in @entity29 ( @entity29 ) is controversial. OBJECTIVES: To assess the effects of psychological interventions (psychotherapy, @entity1 education, relaxation techniques) on health related quality of life, coping, emotional state and disease activity in @entity29 . SEARCH STRATEGY: We searched the specialized register of the @entity29 / @entity8461 Group, CENTRAL (Issue 5, 2010) and from inception to April 2010: Medline, Embase, LILACS, Psyndex, CINAHL, PsyInfo, CCMed, SOMED and Social SciSearch. Conference abstracts and reference lists were also checked. SELECTION CRITERIA: Randomized, quasi-randomized and non randomized controlled trials of psychological interventions in @entity1 or adults with @entity29 with a minimum follow up time of 2 months. DATA COLLECTION AND ANALYSIS: Data were extracted and study quality was independently assessed by two raters. Pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. MAIN RESULTS: Twenty-one studies were eligible for inclusion (1745 @entity1 , 8 RCT, 4 QRCT, 8 NRCT; 19 in adults, 2 in adolescents). Most studies used multimodular approaches. The risk of bias was high for all studies.In adults, psychotherapy had no effect on quality of life at around 12 months (3 studies, 235 @entity1 , SMD -0.07; 95% CI -0.33 to 0.19), emotional status ( @entity308 , 4 studies, 266 @entity1 , SMD 0.03; 95% CI -0.22 to 0.27) or proportion of @entity1 not in remission (5 studies, 287 @entity1 , OR 0.85; 95% CI 0.48 to 1.48). Results were similar at 3 to 8 months. There was no evidence for statistical heterogeneity or subgroup effects based on type of disease or intensity of the therapy. In adolescents, there were positive short term effects of psychotherapy on most outcomes assessed including quality of life (2 studies, 71 @entity1 , SMD 0.70; 95% CI 0.21 to 1.18) and @entity308 (1 study, 41 @entity1 , SMD -0.62; 95% CI -1.25 to 0.01).Educational interventions were ineffective with respect to quality of life at 12 months (5 studies, 947 @entity1 , SMD 0.11; 95% CI -0.02 to 0.24), @entity308 (3 studies, 378 @entity1 , SMD -0.08; 95% CI -0.29 to 0.12) and proportion of @entity1 not in remission (3 studies, 434 @entity1 , OR 1.00; 95% CI 0.65 to 1.53). AUTHORS' CONCLUSIONS: There is no evidence for efficacy of psychological therapy in adult @entity1 with @entity29 in general. In adolescents, psychological interventions may be beneficial, but the evidence is limited. Further evidence is needed to assess the efficacy of these therapies in subgroups identified as being in need of psychological interventions, and to identify what type of therapy maybe most useful.
