Effect of cognitive remediation therapy in anorexia nervosa: a systematic review and meta-analysis.

IF 3.2 3区医学 Q2 PSYCHIATRY Frontiers in Psychiatry Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI:10.3389/fpsyt.2024.1484457

Anas R Alserihi, Wejdan A Hubayni, Solaf Hilal Alotaibi, Sadeem Bahkali, Shatha Alqurashi, Muhannad Sadakah Abualola, Ahmad Mohammed Alsaleh

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Abstract

Background: Anorexia nervosa (AN) can significantly affect cognitive well-being. Cognitive remediation therapy (CRT) is regarded as one of the effective treatments for cognitive impairment in some mental illnesses such as schizophrenia, bipolar disorder, and attention deficit. For this reason, this systematic review and meta-analysis aim to assess the effectiveness of CRT in patients with AN.

Methods: We conducted a search of Medline, ClinicalTrials.gov, and the Cochrane Database of Systematic Reviews from the inception of each database through April 8, 2023. Randomized clinical trials evaluating the effectiveness of CRT in comparison to placebo or other psychological treatments in patients with AN were included. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool. For meta-analysis, effect sizes were measured using mean difference (MD) utilizing the random-effects model and inverse variance (IV) technique. To evaluate the certainty of the evidence, we applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. The study was registered in PROSPERO, ID: CRD42023411784.

Results: In the systematic review, six studies were included, of which four underwent meta-analysis. Among these, three trials encompassing 413 participants showed that CRT was associated with improved cognitive flexibility compared to control at the end of treatment (MD = -0.21, 95% CI [-0.44, 0.02], P=0.81, I² = 0%). In two trials with 143 patients, those who received CRT showed similar effects on the severity of AN symptoms compared to the control group in the self-reporting questionnaires: EDE-Q (MD = -0.25, 95% CI [-0.76, 0.27], P=0.77, I² = 0%) and EDEQOL (MD = -0.19, 95% CI [-0.41, 0.03], P=0.84, I² = 0%).

Conclusion: CRT did not show a statistically significant difference compared to the control group in improving abstract thinking skills and quality of life in individuals with AN. That indicates that CRT's efficacy remains inconclusive. Further research with larger, more diverse samples is needed to determine its long-term effects and potential benefits.

Systematic review registration: PROSPERO, identifier CRD42023411784.

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认知矫正疗法对神经性厌食症的影响：系统回顾和荟萃分析。

背景：神经性厌食症（AN神经性厌食症（AN）会严重影响认知能力。认知矫正治疗（CRT）被认为是治疗精神分裂症、双相情感障碍和注意力缺陷等精神疾病认知障碍的有效方法之一。因此，本系统综述和荟萃分析旨在评估CRT对自闭症患者的疗效：我们对 Medline、ClinicalTrials.gov 和 Cochrane 系统综述数据库进行了检索，检索时间从各数据库建立之初至 2023 年 4 月 8 日。研究纳入了评估CRT与安慰剂或其他心理疗法对AN患者疗效的随机临床试验。研究质量采用修订后的 Cochrane 偏倚风险工具进行评估。在进行荟萃分析时，采用随机效应模型和反方差（IV）技术，以平均差（MD）来衡量效应大小。为了评估证据的确定性，我们采用了建议评估、发展和评价分级（GRADE）标准。该研究已在 PROSPERO 注册，ID：CRD42023411784.Results:系统综述共纳入六项研究，其中四项进行了荟萃分析。其中，有三项包含 413 名参与者的试验表明，与对照组相比，CRT 在治疗结束时与认知灵活性的改善相关（MD = -0.21，95% CI [-0.44, 0.02]，P=0.81，I2 = 0%）。在两项有143名患者参加的试验中，与对照组相比，接受CRT治疗的患者在自我报告问卷中对AN症状的严重程度表现出相似的效果：EDE-Q（MD = -0.25，95% CI [-0.76，0.27]，P=0.77，I2 = 0%）和EDEQOL（MD = -0.19，95% CI [-0.41，0.03]，P=0.84，I2 = 0%）：结论：与对照组相比，CRT在提高AN患者的抽象思维能力和生活质量方面没有显示出统计学上的显著差异。这表明 CRT 的疗效仍无定论。要确定CRT的长期效果和潜在益处，还需要对更大规模、更多样化的样本进行进一步研究：系统综述注册：PROSPERO，标识符为 CRD42023411784。

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.