Cochrane · systematic review · CD001088
Psychosocial interventions for people with both severe mental illness and substance misuse
Hunt, GE, Siegfried, N, Morley, K, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
63
current version
GRADE rated
32
No studies
29
Included studies
NR
No studies 29 · 46%Ungraded 2 · 3.2%Very low 16 · 25.4%Low 14 · 22.2%Moderate 2 · 3.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyIntegrated models of care compared to standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Integrated models of care vs standard care | RR 1.09 [0.82, 1.45] | 3 studies · 603 participants | Low Downgraded: risk of bias, imprecision |
Adverse event: Death Integrated models of care vs standard care | RR 1.18 [0.39, 3.57] | 2 studies · 421 participants | Low Downgraded: risk of bias, imprecision |
Substance use: any change ‐ Alcohol use (not in remission) Integrated models of care vs standard care | RR 1.15 [0.84, 1.56] | 1 study · 143 participants | Low Downgraded: risk of bias, imprecision |
Substance use: any change ‐ Drug use (not in remission) Integrated models of care vs standard care | RR 0.89 [0.63, 1.25] | 1 study · 85 participants | Low Downgraded: risk of bias, imprecision |
Mental state Integrated models of care vs standard care | no estimate extracted | 0 studies · 3 participants | Ungraded |
Global state: average score(GAF scale of 1 ‐ 100) Integrated models of care vs standard care | no estimate extracted | 1 study · 171 participants | Low Downgraded: risk of bias, imprecision |
Quality of life/life satisfaction: avearge score (General life satisfaction) Quality of Life Interview section, scale of 1 to 7 Integrated models of care vs standard care | no estimate extracted | 2 studies · 372 participants | Moderate Downgraded: risk of bias |
Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | RR 1.21 [0.73, 1.99] | 3 studies · 134 participants | Very low Downgraded: risk of bias, imprecision |
Adverse event: Death ‐ not measured Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | NR | No studies |
Substance use: Alcohol ‐ average score (C‐DIS‐R computer program for Diagnostic Interview Schedule: average score) Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug ‐ average score C‐DIS‐R computer program for Diagnostic Interview Schedule: average score Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | NR | No studies |
Mental state: Average score Schizophrenia symptoms on C‐DIS‐R computer program for Diagnostic Interview Schedule: average score Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | NR | No studies |
Global State: Average score (Role Functioning Scale, high = better functioning) Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life/life satisfaction: (Quality of Life Interview section, scale of 1 to 7) Non‐integrated models of care ‐ Assertive community treatment only/Intensive case management/Specialised case management services vs standard care | no estimate extracted | NR | No studies |
Cognitive behavioural therapy versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Cognitive behavioural therapy vs standard care | RR 1.12 [0.44, 2.86] | 2 studies · 152 participants | Low Downgraded: risk of bias, imprecision |
Adverse event: Death Cognitive behavioural therapy vs standard care | no estimate extracted | NR | No studies |
Substance use: Alcohol Cognitive behavioural therapy vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug (Cannabis) Percentage of participants who used cannabis in last 4 weeks Cognitive behavioural therapy vs standard care | RR 1.3 [0.79, 2.15] | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Mental state: average score (Insight scale) Cognitive behavioural therapy vs standard care | no estimate extracted | 1 study · 105 participants | Low Downgraded: risk of bias, imprecision |
Social functioning: Average score* The Social and Occupational Functioning Scale (SOFAS): scale of 1 to 100 Cognitive behavioural therapy vs standard care | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life/ life satisfaction Cognitive behavioural therapy vs standard care | no estimate extracted | NR | No studies |
Contingency management versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Contingency management vs standard care | RR 1.55 [1.13, 2.11] | 2 studies · 255 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse event: Death ‐ not measured Contingency management vs standard care | no estimate extracted | NR | No studies |
Substance use: Alcohol Contingency management vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug (non‐alcohol) Number with stimulant‐positive urine test Contingency management vs standard care | RR 0.83 [0.65, 1.06] | 1 study · 176 participants | Low Downgraded: risk of bias |
Service use*: Number hospitalised Contingency management vs standard care | RR 0.21 [0.05, 0.93] | 1 study · 176 participants | Low Downgraded: risk of bias |
Global state Contingency management vs standard care | no estimate extracted | NR | No studies |
Quality of life/life satisfaction Contingency management vs standard care | no estimate extracted | NR | No studies |
Motivational interviewing versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment Motivational interviewing vs standard care | RR 1.71 [0.63, 4.64] | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Death Motivational interviewing vs standard care | RR 1.04 [0.07, 15.73] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Alcohol use Not abstaining from alcohol Motivational interviewing vs standard care | RR 0.36 [0.17, 0.75] | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use Polydrug consumption levels measured by Opiate Treatment Index (OT) Motivational interviewing vs standard care | no estimate extracted | 1 study · 89 participants | Very low Downgraded: risk of bias, imprecision |
Mental state Symptom Checklist 90‐revised ‐ General Severity Index: Scale 0 to 4: Average score Motivational interviewing vs standard care | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning GAF scale of 1‐ 100 Motivational interviewing vs standard care | no estimate extracted | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life/life satisfaction ‐ not measured Motivational interviewing vs standard care | no estimate extracted | NR | No studies |
Skills training versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Skills training vs standard care | RR 1.42 [0.2, 10.1] | 3 studies · 122 participants | Very low Downgraded: risk of bias, imprecision |
Adverse event: Death Skills training vs standard care | RR 0.15 | 1 study · 121 participants | Low Downgraded: risk of bias |
Substance use: Alcohol (C‐DIS‐R average score) Skills training vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug (non‐alcohol) (C‐DIS‐R average score) Skills training vs standard care | no estimate extracted | NR | No studies |
Mental state Skills training vs standard care | no estimate extracted | NR | No studies |
Social functioning*: Role Functioning Scale: scale 1 to 7 Skills training vs standard care | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life/life satisfaction ‐ not measured Skills training vs standard care | no estimate extracted | NR | No studies |
Cognitive behavioural therapy + motivational interviewing versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Lost to treatment Cognitive behavioural therapy + motivational interviewing vs standard care | RR 0.99 [0.62, 1.59] | 1 study · 327 participants | Low Downgraded: risk of bias, imprecision |
Adverse event: Death Cognitive behavioural therapy + motivational interviewing vs standard care | RR 0.6 [0.2, 1.76] | 4 studies · 603 participants | Low Downgraded: risk of bias, imprecision |
Substance use: Alcohol ( Estimated daily consumption in previous month) Cognitive behavioural therapy + motivational interviewing vs standard care | no estimate extracted | 1 study · 46 participants | Ungraded |
Substance use: Drug (non‐alcohol) use (Average number of different drugs used during the past month measured by the Opiate Treatment Index) Cognitive behavioural therapy + motivational interviewing vs standard care | no estimate extracted | 1 study · 119 participants | Low Downgraded: risk of bias, imprecision |
Relapse:* Relapse at 3 months after 9 months of treatment Cognitive behavioural therapy + motivational interviewing vs standard care | RR 0.5 [0.24, 1.04] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Global State: GAF scale of 1‐ 100 Cognitive behavioural therapy + motivational interviewing vs standard care | no estimate extracted | 4 studies · 445 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life / life satisfaction: Brief Quality of Life Scale Cognitive behavioural therapy + motivational interviewing vs standard care | no estimate extracted | 1 study · 110 participants | Low Downgraded: risk of bias, imprecision |
Cognitive behavioural therapy + psychosocial rehabilitation versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leavint the study early: Loss to Treatment Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision |
Adverse event: Death ‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Substance use: Alcohol ‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug (non‐alcohol) ‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Mental state ‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Global State‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Quality of life/life satisfaction ‐ not measured Cognitive behavioural therapy + psychosocial rehabilitation vs standard care | no estimate extracted | NR | No studies |
Cognitive behavioural therapy + intensive case management versus standard care for both severe mental illness and substance misuse
Population: people with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Leaving the study early: Loss to Treatment Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias |
Adverse event: Death Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
Substance use: alcohol ‐ not measured Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
Substance use: Drug (non‐alcohol) ‐ not measured Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
Mental state ‐ not measured Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
Global State ‐ not measured Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
Quality of life/life satisfaction ‐ not measured Cognitive behavioural therapy + intensive case management vs standard care | no estimate extracted | NR | No studies |
INTEGRATED MODELS OF CARE compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: People with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment INTEGRATED MODELS OF CARE vs TREATMENT | RR 1.09 [0.82, 1.45] | 3 studies · 603 participants | Low Downgraded: risk of bias, imprecision |
Death INTEGRATED MODELS OF CARE vs TREATMENT | RR 1.18 [0.39, 3.57] | 2 studies · 421 participants | Low Downgraded: risk of bias, imprecision |
Alcohol use: Not in remission INTEGRATED MODELS OF CARE vs TREATMENT | RR 1.15 [0.84, 1.56] | 1 study · 143 participants | Low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use: Not in remission INTEGRATED MODELS OF CARE vs TREATMENT | RR 0.89 [0.63, 1.25] | 1 study · 85 participants | Low Downgraded: risk of bias, imprecision |
Mental state Days of hospitalisation INTEGRATED MODELS OF CARE vs TREATMENT | no estimate extracted | 0 studies · 3 participants | Ungraded |
Global Assessment of Functioning GAF scale of 1 ‐ 100 INTEGRATED MODELS OF CARE vs TREATMENT | no estimate extracted | 1 study · 171 participants | Low Downgraded: risk of bias, imprecision |
General life satisfaction Quality of Life Interview section, scale of 1 to 7 INTEGRATED MODELS OF CARE vs TREATMENT | no estimate extracted | 2 studies · 372 participants | Moderate Downgraded: risk of bias |
NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: People with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | RR 1.21 [0.73, 1.99] | 3 studies · 134 participants | Very low Downgraded: risk of bias, imprecision |
Death ‐ not measured NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Alcohol use C‐DIS‐R computer program for Diagnostic Interview Schedule: average score NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use C‐DIS‐R computer program for Diagnostic Interview Schedule: average score NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Mental state Schizophrenia symptoms on C‐DIS‐R computer program for Diagnostic Interview Schedule: average score NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning Role Functioning Scale NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
General life satisfaction Quality of Life Interview section, scale of 1 to 7 NON‐INTEGRATED MODELS OF CARE OR INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision |
COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 0.99 [0.62, 1.59] | 1 study · 327 participants | Low Downgraded: risk of bias, imprecision |
Death COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 0.72 [0.22, 2.41] | 3 studies · 493 participants | Low Downgraded: risk of bias, imprecision |
Alcohol use Estimated daily consumption in previous month COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 46 participants | Ungraded |
Drug (non‐alcohol) use Average number of different drugs used during the past month measured by the Opiate Treatment Index COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 119 participants | Low Downgraded: risk of bias, imprecision |
Mental state Relapse at 3 months after 9 months of treatment COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 0.5 [0.24, 1.04] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning GAF scale of 1‐ 100 COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 4 studies · 445 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
General life satisfaction Brief Quality of Life Scale COGNITIVE BEHAVIOUR THERAPY + MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 110 participants | Low Downgraded: risk of bias, imprecision |
COGNITIVE BEHAVIOUR THERAPY compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | RR 1.12 [0.44, 2.86] | 2 studies · 152 participants | Low Downgraded: risk of bias, imprecision |
Death COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | no estimate extracted | 0 studies · 0 participants | Ungraded |
Alcohol use COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | no estimate extracted | 1 study · 105 participants | Low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use: Cannabis Percentage of participants who used cannabis in last 4 weeks COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | RR 1.3 [0.79, 2.15] | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Mental state General symptoms on Brief Psychiatric Rating Scale COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | no estimate extracted | 1 study · 105 participants | Low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning The Social and Occupational Functioning Scale (SOFAS): scale of 1 to 100 COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
General life satisfaction COGNITIVE BEHAVIOUR THERAPY vs TREATMENT | no estimate extracted | 0 studies · 0 participants | Ungraded |
COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss to Treatment COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision |
Death ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
Alcohol use ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
Drug (non‐alcohol) use ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
Mental state ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
Global Assessment of Functioning ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
General life satisfaction ‐ not measured COGNITIVE BEHAVIOUR THERAPY and PSYCHOSOCIAL REHABILITATION vs TREATMENT | no estimate extracted | NR | No studies |
COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss to Treatment COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias |
Death COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 0 studies · 0 participants | Ungraded |
Alcohol use ‐ not measured COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Drug (non‐alcohol) use ‐ not measured COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Mental state ‐ not measured COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Global Assessment of Functioning ‐ not measured COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
General life satisfaction ‐ not measured COMBINED COGNITIVE BEHAVIOUR THERAPY and INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
INTENSIVE CASE MANAGEMENT compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss to Treatment INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 101 participants | Very low Downgraded: risk of bias, imprecision |
Death ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Alcohol use ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Drug (non‐alcohol) use ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Mental state ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Global Assessment of Functioning ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
General life satisfaction ‐ not measured INTENSIVE CASE MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
MOTIVATIONAL INTERVIEWING compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 1.71 [0.63, 4.64] | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Death MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 1.04 [0.07, 15.73] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Alcohol use Not abstaining from alcohol MOTIVATIONAL INTERVIEWING vs TREATMENT | RR 0.36 [0.17, 0.75] | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use Polydrug consumption levels measured by Opiate Treatment Index (OT) MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 89 participants | Very low Downgraded: risk of bias, imprecision |
Mental state Symptom Checklist 90‐revised ‐ General Severity Index: Scale 0 to 4: Average score MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning GAF scale of 1‐ 100 MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
General life satisfaction ‐ not measured MOTIVATIONAL INTERVIEWING vs TREATMENT | no estimate extracted | NR | No studies |
SKILLS TRAINING compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment SKILLS TRAINING vs TREATMENT | RR 0.7 [0.44, 1.1] | 2 studies · 94 participants | Very low Downgraded: risk of bias, imprecision |
Death ‐ not measured SKILLS TRAINING vs TREATMENT | no estimate extracted | NR | No studies |
Alcohol use C‐DIS‐R average score SKILLS TRAINING vs TREATMENT | no estimate extracted | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use C‐DIS‐R average score SKILLS TRAINING vs TREATMENT | no estimate extracted | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Mental state Relapse measured by days in hospital SKILLS TRAINING vs TREATMENT | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning Role Functioning Scale: scale 1 to 7 SKILLS TRAINING vs TREATMENT | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
General life satisfaction ‐ not measured SKILLS TRAINING vs TREATMENT | no estimate extracted | NR | No studies |
SPECIALISED CASE MANAGEMENT SERVICES compared to STANDARD CARE for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss to Treatment ‐ not measured SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | NR | No studies |
Death ‐ not measured SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | NR | No studies |
Alcohol use Unpublished drug and alcohol questionnaire SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision |
Drug (non‐alcohol) use Unpublished drug and alcohol questionnaire SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision |
Mental state Days of admission SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | 1 study · 56 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Global Assessment of Functioning ‐ not reported SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | NR | No studies |
General life satisfaction ‐ not measured SPECIALISED CASE MANAGEMENT SERVICES vs STANDARD CARE | no estimate extracted | NR | No studies |
CONTINGENCY MANAGEMENT compared to TREATMENT AS USUAL for both severe mental illness and substance misuse
Population: patients with both severe mental illness and substance misuse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lost to treatment CONTINGENCY MANAGEMENT vs TREATMENT | RR 1.65 [1.18, 2.31] | 1 study · 176 participants | Low Downgraded: risk of bias, imprecision |
Death ‐ not measured CONTINGENCY MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
Alcohol use Mean days of alcohol use in 6 months CONTINGENCY MANAGEMENT vs TREATMENT | no estimate extracted | 1 study · 107 participants | Ungraded |
Drug (non‐alcohol) use Number with stimulant‐positive urine test CONTINGENCY MANAGEMENT vs TREATMENT | RR 0.83 [0.65, 1.06] | 1 study · 176 participants | Low Downgraded: risk of bias, imprecision |
Mental state Number hospitalised CONTINGENCY MANAGEMENT vs TREATMENT | RR 0.21 [0.05, 0.93] | 1 study · 176 participants | Low Downgraded: risk of bias, imprecision |
Global Assessment of Functioning ‐ not measured CONTINGENCY MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |
General life satisfaction ‐ not measured CONTINGENCY MANAGEMENT vs TREATMENT | no estimate extracted | NR | No studies |