Background
Aims of the study
Methods
Eligibility criteria
Types of trials
Types of participants
Types of interventions
Types of outcome measures
Search strategy
Assessment of bias
Data management
Statistical analysis
Results
Trial flow
Study characteristics
Study | Location | No. | DiagnosisΦ
| Age (yr) | Sex (F) | Race (BME) | EmploymentΩ
|
---|---|---|---|---|---|---|---|
Mutual Support
| |||||||
Edmundson 1982 [51] | Florida USA
| 80 | N/R | N/R | N/R | N/R | N/R |
Kaplan 2011 [47]ψ
| Pennsylvania USA
| 300 | 22% SS 78% mood | 47 | 66% | 13% | 64% |
Rogers 2007 [42] | Multiple sites USA
| 1827 | 50% SS 44% mood | 43 | 60% | 43% | 29% |
Segal 2011 [49] | California USA
| 162 | 41% SS 59% mood | 37 | 54% | 13% | 4% |
Peer Support
| |||||||
Barbic 2009 [39] | Ontario CA
| 33 | 79% SS 21% BPD | 45 | 33% | N/R | 12% |
Chinman 2013 [36] | South Western USA | 282α
| 53 | 11% | 46% | N/R | |
Cook 2012 [46] | Tennessee, USA
| 428 | 21% SS 40% BPD 18% mood | 43 | 56% | 54% | 9% |
Cook 2011 [45] | Ohio USA
| 555 | 20% SS 26% BPD, 24% MDD | 46 | 66% | 37% | 15% |
Craig 2004 [38] | London UK
| 45 | 100% SS | 38 | 33% | N/R | N/R |
Davidson 2004 [41] | Connecticut USA
| 260 | 50% SS 34% mood | 42 | 57% | 18% | 20% |
Proudfoot 2012 [37] | New South Wales Australia
| 407 | 100% BPD | N/R | 70% | N/R | N/R |
Rivera 2007 [48] | New York USA
| 255 | 48% SS 26% BPD 22% MDD | 38 | 49% | 71% | N/R |
Simon 2011 [27] |
USA
| 118 | 100% BPD | N/R | 72% | 19% | N/R |
Sledge 2011 [44] | Connecticut USA
| 89 | 69% SS 31% mood | 41 | 49% | N/R | N/R |
Van Gestel-Timmermans 2012 [50] |
Netherlands
| 333 | 33% SS | 44 | 66% | N/R | N/R |
Peer Delivered Services
| |||||||
Sells 2006 [43] | Connecticut USA
| 137 | 61% SS 70% multiple | 42 | 39% | 11% | N/R |
Clarke 2000 [40] | Oregon USA
| 178 | 60% SS31% SM | 37 | 39% | 18% | N/R |
Solomon 1995 [28] | Pennsylvania USA
| 96 | 82% SS 12% mood | 41 | 47% | 37% | N/R |
Risk of bias
Quantitative data synthesis
Post-treatment
Outcome |
Trials
|
Participants
|
Effect size (95% CI)
|
Heterogeneity: I
2
;Chi2
(p value)
|
Follow-up (months)
|
GRADE confidence rating
|
---|---|---|---|---|---|---|
Mutual Support
|
4
|
2369
| ||||
Hospitalisation [51] | 1 | 80 | RR = 0.50 (0.23, 1.11) | N/A | 10 | Very low1,4,5
|
Symptoms of psychosis | 0 | N/A | N/A | N/A | N/A | N/A |
Employment | 0 | N/A | N/A | N/A | N/A | N/A |
Quality of life [47] | 1 | 300 | SMD = -1.42 (-1.69, – 1.16) | N/A | 12 | Very low1,4,5
|
Overall psychiatric symptoms [49] | 1 | 162 | N/A “no difference in change” | N/A | N/A | N/A |
Depression and anxiety [47] | 1 | 300 | SMD = -0.42 (-0.66, – 0.18) | N/A | 12 | Very low1,4,5
|
Recovery [47] | 1 | 300 | SMD = -0.11 (-0.35, 0.13) | N/A | 12 | Very low1,4,5
|
Hope [49] | 1 | 162 | N/A “no difference in change” | N/A | N/A | N/A |
3 | 2266 | SMD = -1.44 (-2.79, – 0.09) | 99%; 186.26 (p < 0.001) | 8-12 | Very low1,2,4,5
| |
Satisfaction | 0 | N/A | N/A | N/A | N/A | N/A |
Peer-support
|
11
|
2805
| ||||
Hospitalisation [38] | 1 | 45 | RR = 1.07 (0.55, 2.07) | N/A | 9-12 | Very low1,4,5
|
3 | 255 | SMD = -0.22 (-0.72, 0.28) | 72%; 7.16 (p = 0.03) | Very low1,2,4,5
| ||
2 | 696 | SMD = -0.08 (-0.27, 0.03) | N/A | 2-12 | Low4,5
| |
Employment | 0 | N/A | N/A | N/A | N/A | N/A |
5 | 1039 | SMD = 0.04 (-0.16, 0.24) | 52%; 8.38 (p = 0.08) | 3-12 | Very low1,4,5
| |
3 | 861 | SMD = -0.10 (-0.24, 0.03) | 0%; 1.97 (p = 0.37) | 2-12 | Low4,5
| |
3 | 753 | SMD = -0.07 (-0.39, 0.24) | 74%; 7.83 (p = 0.02) | 3-9 | Very low 1,2,4,5
| |
4 | 1066 | SMD = -0.24 (-0.39, – 0.09) | 27%; 4.09 (p = 0.25) | 2-12 | Low4,5
| |
4 | 1072 | SMD = -0.14 (-0.27, -0.02) | 7%; 3.21 (p = 0.36) | 2-3 | Very low 1,4,5
| |
2 | 286 | SMD = -2.67 (-7.35, 2.02) | 97%; 38.87 (p < 0.001) | 3 | Very low1,2*,4,5
| |
3 | 332 | SMD = 0.02 (-0.20, 0.23) | 0%; 0.95 (p = 0.62) | 9-12 | Very low1,4,5
| |
Peer delivered services
|
3
|
411
| ||||
Hospitalisation [40] | 1Ψ
| 114 | RR = 0.68 [0.45, 1.03] | N/A | 24 | Very Low1,4,5
|
Symptoms of psychosis | 0 | N/A | N/A | N/A | N/A | N/A |
Employment [28] | 1 | 96 | N/A “no differences”
|
N/A
|
N/A
|
N/A
|
Quality of life (SMD) [28] | 1 | 96 | N/A “no differences”
|
N/A
|
N/A
|
N/A
|
Depression and anxiety | 0 | N/A | N/A | N/A | N/A | N/A |
Overall psychiatric symptoms | 0 | N/A | N/A | N/A | N/A | N/A |
Recovery | 0 | N/A | N/A | N/A | N/A | N/A |
Hope | 0 | N/A | N/A | N/A | N/A | N/A |
Empowerment | 0 | N/A | N/A | N/A | N/A | N/A |
Satisfaction [28] | 1 | 87 | SMD = 0.48 (0.05, 0.91) | N/A | 12 | Very low1,4,5
|
Follow-up
Outcome |
Trials
|
Participants
|
Effect size (95% CI)
|
Heterogeneity: I
2
;Chi2
(p value)
|
Follow-up (months post-treatment )
|
GRADE confidence rating
|
---|---|---|---|---|---|---|
Peer support
| 4 | 1723 | ||||
Hospitalisation | 0 | N/A | N/A | N/A | N/A | N/A |
Symptoms of psychosis [45] | 1 | 448 | SMD = -0.00 (-0.19, 0.18) | N/A | 6 | Low 4,5
|
Employment | 0 | N/A | N/A | N/A | N/A | N/A |
2 | 639 | SMD = -0.24 (-0.40, -0.08) | 0%; 0.00 (p = 0.98) | 3-6 | Very low1, 4, 5
| |
2 | 721 | SMD = -0.17 (-0.32, -0.03) | 0%; 0.15 (p = 0.70) | 6 | Low4,5
| |
Overall psychiatric symptoms [45] | 1 | 448 | SMD = -0.08 (-0.26, 0.11) | N/A | 6 | Low4,5
|
2 | 757 | SMD = -0.23 (-0.37, -0.09) | 0%, 0.71 (p = 0.40) | 6 | Low4,5
| |
3 | 967 | SMD = -0.24 (-0.46, -0.02) | 65%; 5.74 (p = 0.06) | 3-6 | Very low1,2,4,5
| |
2 | 538 | SMD = -0.25 (-0.43, -0.07) | 12%; 1.13 (p = 0.29) | 6 | Very low1,4,5
| |
Satisfaction | 0 | N/A | N/A | N/A | N/A | N/A |