Psychiatry

Targeted psychological interventions yield small-to-moderate reductions in auditory hallucinations; avatar therapy best supported.

Meta-analysis of 23 RCTs (N=2016) found targeted psychological interventions reduced auditory hallucination severity at posttreatment (SMD -0.18, NNT 16). Effects extended to hallucination frequency, distress, positive symptoms, delusions, depression, and anxiety. Avatar therapy produced the largest effect (SMD -0.37) compared with other targeted approaches. Acceptability and dropout rates were generally favourable, but overall evidence certainty was rated low by GRADE. 1

Inflammatory protein markers weakly and inconsistently predict psychiatric treatment outcomes across diagnoses.

Systematic review/meta-analysis included 105 studies (42 meta-analysed; pooled N=5787) across MDD, schizophrenia, and BD. IL-6 showed no association with treatment outcome, while TNF-α declines in responders had a pooled SMD 0.75 in limited samples. Low versus high baseline CRP associated with higher remission odds in some analyses (OR 1.84), but cutoffs varied across studies. Heterogeneity was high and findings were largely driven by MDD data, limiting cross‑diagnostic clinical application. 2

A 4‑week self‑guided app (inMind) produced modest short‑term stress reductions as an adjunct to medication for mild–moderate MDD.

Randomized crossover pilot (N=39, analysed N=36) found inMind reduced DASS‑Stress by an estimated -2.41 points (p=0.047). Directionally consistent reductions were seen in depressive and anxiety symptoms, near the published MCID for stress. Significant carry‑over effects from the no‑washout crossover design limit causal inference. Adherence was high and the intervention appears feasible as a low‑intensity adjunct while awaiting larger trials. 3