Cochrane · systematic review · CD006995
Antiglucocorticoid and related treatments for psychosis
Garner, B, Phillips, LJ, Bendall, S, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SchizophreniaAMSTAR 2: not assessed
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
20
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 6 · 30%Very low 3 · 15%Low 9 · 45%Moderate 2 · 10%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
Any antiglucocorticoid compared with placebo as sole treatment (data only for mifepristone) for psychosis
Population: people with psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mental state: 1. General ‐ average endpoint score BPRS total scores Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 5 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Mental state: 2. Specific ‐ depression ‐ average endpoint score HAMD total Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 5 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Global state: 1. General ‐ no clinically significant improvement ‐ short term < 30% improvement on BPRS Any antiglucocorticoid vs placebo | RR 0.58 [0.38, 0.89] | 1 study · 221 participants | Low Downgraded: risk of bias, indirectness |
Global state: 2. Specific: positive ‐ no clinically significant improvement ‐ short term (< 50% improvement on BPRS PSS) Any antiglucocorticoid vs placebo | RR 0.6 [0.43, 0.84] | 1 study · 221 participants | Low Downgraded: risk of bias, indirectness |
General functioning: improved to an important degree Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects: general: overall number of events Any antiglucocorticoid vs placebo | RR 0.92 [0.77, 1.09] | 2 studies · 226 participants | Moderate Downgraded: risk of bias |
Quality of life: improved to an important degree Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Any antiglucocorticoid compared with placebo as adjunct to atypical antipsychotic treatment (data only for DHEA) for psychosis
Population: people with psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mental state: 1. General ‐ average endpoint score PANSS total Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Mental state: 2. Specific ‐ negative symptoms ‐ average endpoint score PANSS subscale Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Global state: general ‐ no clinically significant improvement Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
General functioning: improved to an important degree Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Adverse effects: specific: extrapyramidal symptoms ‐ average endpoint scores parkinsonism SAS total Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Quality of life: improved to an important degree Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Any antiglucocorticoid compared with placebo as adjunct to combination treatment for psychosis
Population: people with psychosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mental state: 1. General ‐ average endpoint score ‐ short term ‐ only mifepristone BPRS total Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Mental state: 2. Specific ‐ negative symptoms ‐ average endpoint scores ‐ immediate PANSS negative subscale Any antiglucocorticoid vs placebo | no estimate extracted | 2 studies · 70 participants | Low Downgraded: risk of bias, inconsistency |
Global state: general ‐no clinically significant improvement ‐ data only for mifepristone < 30% improvement on BPRS Any antiglucocorticoid vs placebo | RR 0.58 [0.32, 1.06] | 1 study · 30 participants | Very low Downgraded: risk of bias, indirectness |
General functioning: average endpoint scores ‐ data only for DHEA GAF/SOFA Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 30 participants | Low Downgraded: risk of bias |
Adverse effects: 1. General ‐ overall number of events Any antiglucocorticoid vs placebo | RR 2.66 [1.33, 5.32] | 7 studies · 199 participants | Moderate Downgraded: risk of bias |
Adverse events: 2. Specific ‐ extrapyramidal symptoms ‐ average endpoint scores ‐ data only for DHEA SHRS total Any antiglucocorticoid vs placebo | no estimate extracted | 1 study · 30 participants | Low Downgraded: risk of bias |
Quality of life: improved to an important degree Any antiglucocorticoid vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |