The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia

Abstract

Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some criticalmoderating factors. A systematic literature searchwas conducted yielding 12986 published reports, 2043 ofwhichwere clinical trials. After a detailed review, 36 articleswere included in the analyses. Measures of related concepts,well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes ofwell-being. Subgroup analysis also suggested a significant moderating effectwhen the primary aimof the intervention waswell-being. These findings suggest that symptomor functional improvement does not necessarily lead to an improvement inwell-being and would imply the need to focus specifically on those.We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.