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This meta-analysis included 23 studies involving 2,016 participants with schizophrenia-spectrum and other psychotic disorders, examining targeted psychological interventions for auditory hallucinations. Compared with control conditions, interventions produced a small but statistically significant reduction in hallucination severity immediately after treatment (standardized mean difference [SMD], −0.18; 95% CI, −0.31 to −0.05; \(p=0.007\); number needed to treat, 16). Benefits were also observed for hallucination frequency (SMD, −0.28; 95% CI, −0.45 to −0.10) and associated distress (SMD, −0.19; 95% CI, −0.34 to −0.04). Avatar therapy appeared particularly promising in subgroup analyses. However, effects on beliefs about the hallucinations were not statistically significant, and the certainty of evidence for the main outcome was rated low. The findings support targeted psychological approaches as potential adjuncts to usual care, while highlighting the need for better-powered and methodologically rigorous trials.
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This meta-analysis included 23 studies involving 2,016 participants with schizophrenia-spectrum and other psychotic disorders, examining targeted psychological interventions for auditory hallucinations. Compared with control conditions, interventions produced a small but statistically significant reduction in hallucination severity immediately after treatment (standardized mean difference [SMD], −0.18; 95% CI, −0.31 to −0.05; \(p=0.007\); number needed to treat, 16). Benefits were also observed for hallucination frequency (SMD, −0.28; 95% CI, −0.45 to −0.10) and associated distress (SMD, −0.19; 95% CI, −0.34 to −0.04). Avatar therapy appeared particularly promising in subgroup analyses. However, effects on beliefs about the hallucinations were not statistically significant, and the certainty of evidence for the main outcome was rated low. The findings support targeted psychological approaches as potential adjuncts to usual care, while highlighting the need for better-powered and methodologically rigorous trials.
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