Background and Hypothesis Substance use is highly prevalent among people with schizophrenia (SCZ) and related disorders, however, there is no broad-spectrum pharmacotherapy that concurrently addresses both addiction and psychotic symptoms. Psychosocial (PS) interventions, which have yielded promising results in treating psychosis and substance dependence separately, demonstrate potential but have not been systematically evaluated when combined. Study Design Systematic review and random-effects meta-analyses of randomized controlled trials (RCTs) investigating PS interventions for individuals with comorbid substance use and psychotic disorders, encompassing SCZ and schizophrenia spectrum disorders (SSD). We included relevant studies published from MEDLINE, PsycINFO, and Google Scholar through May 2023. Study Results We included 35 RCTs (5176 participants total; approximately 2840 with SSD). Intervention durations ranged from 30 min to 3 years. Meta-analysis did not identify a statistically significant pooled PS intervention effect on the main primary outcome, substance use (18 studies; 803 intervention, 733 control participants; standardized mean difference, −0.05 standard deviation [SD]; 95% CI, −0.16, 0.07 SD; I2 = 18%). PS intervention effects on other outcomes were also not statistically significant. Overall GRADE certainty of evidence was low. Conclusions At present, the literature lacks sufficient evidence supporting the use of PS interventions as opposed to alternative therapeutic approaches for significantly improving substance use, symptomatology, or functioning in people with SCZ and related disorders. However, firm conclusions were precluded by low certainty of evidence. Further RCTs are needed to determine the efficacy of PS treatments for people with dual-diagnoses (DD), either alone or in combination with pharmacotherapy.

中文翻译：

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对患有共存精神病和药物使用障碍的个体的心理社会干预：随机研究的系统回顾和荟萃分析


背景和假设 物质使用在精神分裂症 (SCZ) 和相关疾病患者中非常普遍，然而，没有同时解决成瘾和精神病症状的广谱药物疗法。社会心理（PS）干预措施在单独治疗精神病和物质依赖方面已取得了可喜的成果，显示出潜力，但组合使用时尚未得到系统评估。研究设计 对随机对照试验 (RCT) 进行系统回顾和随机效应荟萃分析，研究对患有共病物质使用和精神障碍（包括 SCZ 和精神分裂症谱系障碍 (SSD)）的个体的 PS 干预措施。我们纳入了截至 2023 年 5 月从 MEDLINE、PsycINFO 和 Google Scholar 发表的相关研究。研究结果 我们纳入了 35 项随机对照试验（总共 5176 名受试者；大约 2840 名 SSD 受试者）。干预持续时间从30分钟到3年不等。荟萃分析未发现综合 PS 干预对主要主要结局物质使用具有统计显着性影响（18 项研究；803 项干预措施，733 名对照参与者；标准化均差，-0.05 标准差 [SD]；95% CI，-0.16 ，0.07 SD；I2 = 18%）。 PS 干预对其他结果的影响也没有统计学意义。证据的总体 GRADE 确定性较低。结论 目前，文献缺乏足够的证据支持使用 PS 干预措施而不是替代治疗方法来显着改善 SCZ 和相关疾病患者的物质使用、症状或功能。然而，由于证据质量低，无法得出确切的结论。 需要进一步的随机对照试验来确定 PS 治疗对双重诊断 (DD) 患者的疗效，无论是单独治疗还是与药物治疗联合治疗。