The efficacy of psychoeducation-based programs on internalized stigma in patients with schizophrenia: A systematic...

Trials examining the efficacy of psychoeducation-based programs in reducing internalized stigma in patients with schizophrenia have mainly focused on short-term efficacy, with the effects of specific potential moderators unclear. Hence, we conducted this systematic review and meta-analysis to fill in these gaps. A systematic search of six databases was conducted and twelve randomized clinical trials (RCTs) were included. The findings indicated that psychoeducation-based programs significantly reduce internalized stigma with a large effect size in short-term efficacy defined (at <3 months (SMD = -0.92, 95 % CI:1.48 to -0.37, P = 0.00). However, the efficacy was not statistically significant for medium-term (at 3 to 6 months, SMD = -0.42, 95 % CI:0.95 to 0.11, P = 0.12) and long-term efficacy (at > 6 months, SMD = -1.09, 95 % CI:2.29 to 0.11, P = 0.07). Further mechanism-based, theory-driven and multilevel interventions for reducing internalized stigma in patients with schizophrenia are urgent needed. Notably, sample size, dosage, duration, length per session, data analysis techniques for handling missing data, and type of control group might be potential moderators of the programs on short-term outcomes. More rigorous, multicenter and larger-sample size RCTs are warranted to enhance the validity of these findings. PROSPERO REGISTRATION NUMBER: CRD42024497678.