The Effect of Social Cognitive Interaction Training on Schizophrenia: A Systematic Review and Meta-Analysis of Comparison with Conventional Treatment

Abstract

Background. Existing antipsychotic medications may alleviate the majority of patients’ symptoms, but they have no discernible impact on improving social function and quality of life. Psychotherapy is required for the treatment of schizophrenia. However, contemporary psychotherapy technology intervention techniques are limited to a single intervention, and there is a lack of holistic and complete intervention approaches. Social cognition and interaction training is a comprehensive therapy strategy that has been employed in clinical practice; however, the therapeutic efficacy has been inconsistently reported. As a result, we included controlled clinical trials for meta-analysis in order to carefully assess the efficacy of this therapy. Methods. This meta-analysis searched all RCT literatures related to social cognitive interaction training (SCIT) published before April 2022 and assessed the effect of this method in the treatment of schizophrenia. The data in the literatures were combined, and the standardized mean difference (SMD) and mean difference (MD) with 95% confidence interval (95% CI) were calculated to predict the negative symptom score, positive symptom score, PANSS score, and social function score of the patients after treatment. Results. 14 RCT studies including 1167 inpatients with schizophrenia were included in this study using a retrospective observational study method, including 590 patients treated with SCIT and 577 patients treated with treatment as usual (TAU). The pooled analysis showed that patients after SCIT had lower negative symptom scores ( $\text{SMD}=-1.66$ , 95% CI (-2.32, -1.00), $P<0.0001$ ), lower positive symptom scores ( $\text{MD}=-4.03$ , 95% CI (-7.69, -0.36), $P=0.03$ ), lower PANSS total scores ( $\text{MD}=-6.33$ , 95% CI (-12.43, -0.23), $P=0.02$ ), and higher social functioning scores ( $\text{SMD}=0.77$ , 95% CI (0.34, 1.20), $P<0.001$ ) than those after TAU. Conclusion. Our findings support that SCIT is helpful to improve the relief of symptoms and the improvement of social function in patients with schizophrenia, providing a basis for the application of SCIT in hospitalized patients and community patients, and can guide the treatment and intervention of patients with schizophrenia.