Schizophrenia and other psychotic disorders are chronic and debilitating conditions. [1] Antipsychotic medications are the first line of treatment for psychosis and traditionally they have focused on reducing the frequency and intensity of psychotic symptoms without being fully effective in functional improvement. [2, 3] Many patients continued having positive symptoms (auditory hallucinations and delusions) and negative symptoms (apathy, emotional and social withdrawal) due to lack of treatment adherence, relapse, or cognitive problems, increasing the possibility of re-hospitalization. [4, 5] Cognitive-behavioral and family therapies [6-8] have been shown to produce benefits beyond medications alone. The Schizophrenia Patient Outcomes Research
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[14] ACT is a contextual form of CBT based on the view that many maladaptive behaviors are produced by “unhealthy attempts to avoid or suppress thoughts, feelings, or bodily sensations” [15, 16] The general goal of ACT is to increase the ability to contact the present moment more fully and to change and maintain behaviors based on ones values in order to live a vital life. This is called psychological flexibility and is established through six core ACT processes: acceptance (contacting private experiences without changing those experiences) , cognitive defusion (creating distance from thoughts and noticing thoughts), being present (experiencing the present moment without evaluation), self as context (observing experiences of one’s self in their current circumstances and environment), values (defining meaningful life directions), and committed action (making behavior changes in a valued) . [14] A growing number of studies over the past two decades support the use of ACT for several disorders. [14] Randomized controlled trials have shown that ACT is beneficial for anxiety and depression [17-21] , depression alone [22], physical health problems [23, 24], substance use disorder, and other mental disorders [25, 26] In addition, the U.S. Department of Veterans Affairs disseminated ACT for depression as part of …show more content…
Analysis: Mantel and Haenszel approach was used to determine the heterogeneity in the study. [38] Heterogeneity was measured using I square. In this study, I square value above 75% was considered indicative of significant heterogeneity effect. In absence of heterogeneity, the fixed effects model was considered as the final model for estimating the effect size and 95% confidence interval (CI). Since we did not find significant heterogeneity effect, a fixed effect model was used to obtain the combined effect of ACT on various outcomes as compared to TAU. For quantitative outcomes, standardized mean difference (SMD) between ACT and TAU was used to summarize effect size while relative risk (RR) was used for categorical outcomes along with 95% confidence interval (CI). Forest plot was used to demonstrate the important finding in the study. All the statistical analysis was carried out using STATA 12.1. P-values less than 5% were considered as significant
[14] ACT is a contextual form of CBT based on the view that many maladaptive behaviors are produced by “unhealthy attempts to avoid or suppress thoughts, feelings, or bodily sensations” [15, 16] The general goal of ACT is to increase the ability to contact the present moment more fully and to change and maintain behaviors based on ones values in order to live a vital life. This is called psychological flexibility and is established through six core ACT processes: acceptance (contacting private experiences without changing those experiences) , cognitive defusion (creating distance from thoughts and noticing thoughts), being present (experiencing the present moment without evaluation), self as context (observing experiences of one’s self in their current circumstances and environment), values (defining meaningful life directions), and committed action (making behavior changes in a valued) . [14] A growing number of studies over the past two decades support the use of ACT for several disorders. [14] Randomized controlled trials have shown that ACT is beneficial for anxiety and depression [17-21] , depression alone [22], physical health problems [23, 24], substance use disorder, and other mental disorders [25, 26] In addition, the U.S. Department of Veterans Affairs disseminated ACT for depression as part of …show more content…
Analysis: Mantel and Haenszel approach was used to determine the heterogeneity in the study. [38] Heterogeneity was measured using I square. In this study, I square value above 75% was considered indicative of significant heterogeneity effect. In absence of heterogeneity, the fixed effects model was considered as the final model for estimating the effect size and 95% confidence interval (CI). Since we did not find significant heterogeneity effect, a fixed effect model was used to obtain the combined effect of ACT on various outcomes as compared to TAU. For quantitative outcomes, standardized mean difference (SMD) between ACT and TAU was used to summarize effect size while relative risk (RR) was used for categorical outcomes along with 95% confidence interval (CI). Forest plot was used to demonstrate the important finding in the study. All the statistical analysis was carried out using STATA 12.1. P-values less than 5% were considered as significant