METHODS
This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement for the meta-analyses of RCTs. A number of databases were searched, including PubMed, Medline, OVID, Cochrane Library, EMBASE, CINAHL plus, and PsycINFO. References from selected articles were also reviewed. The inclusion criteria included: (1) RCT, (2) patients aged 18 years or above, (3) presence of comparison group, (4) availability of at least one relevant outcome such as changes in the relapse rate, depressive symptoms, mania severity, and psychosocial functioning, such as HRSD, YMRS, GAF. The exclusion criteria were (1) no relevant data were available for further meta-analysis, and (2) non-RCT. Studies using psychological therapies based on CBT or CBT-modified programs were also included. [6]
The data was extracted by two independent reviewers, and consensus meeting with a third researcher was held to resolve disputes. Quality-control process was done by another researcher according to Cochrane Collaboration's tool for assessing the risk of bias in randomized trials.
Statistical outcomes included odds ratio for relapse, and effect size in terms of Hedges’ g for continuous outcomes. Random effects model was applied. Subgroup analysis, sensitivity analysis and publication bias was also assessed.