OBJECTIVE Acceptance and commitment therapy (ACT) is a third-wave psychological intervention that has attracted considerable clinical and research attention. A previous meta-analysis of ACT trials in psychosis reported a large effect size of ACT against overall psychotic symptomatology. However, there were critical methodological issues in the review that justify replication. METHODS Systematic review and meta-analysis of randomized controlled trials (RCTs) testing ACT vs. any comparator condition in a sample of adults with psychosis. The outcome of interest was overall psychotic symptomatology. RESULTS The search identified seven published and eight unpublished trials (of which we were able to obtain data from one). Data on symptomatology were extracted from six trials that involved 274 participants. The summary effect size (Hedge's G) for overall symptomatology was small and not significant (-0.21, 95%CI -0.60-0.18). Trials were generally rated as having a high risk of bias. Safety reporting was inadequate across included trials. CONCLUSIONS Our observed effect size contrasted with that reported in a previous meta-analysis; differences were likely explained by errors in data extraction. The findings of this review suggest that there is currently inadequate evidence to conclude that ACT is a safe and effective treatment against psychotic symptomatology. Systematic review registration: CRD42018097200.

中文翻译：

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接受和承诺疗法对抗精神病症状的安全性和有效性：系统评价和荟萃分析

目标接受和承诺疗法（ACT）是第三波心理干预，引起了相当多的临床和研究关注。先前对精神病中 ACT 试验的荟萃分析报告了 ACT 对整体精神病症状的巨大影响。然而，审查中存在关键的方法论问题，证明复制是合理的。方法 在精神病成人样本中测试 ACT 与任何比较条件的随机对照试验 (RCT) 的系统评价和荟萃分析。感兴趣的结果是整体精神病症状。结果 搜索确定了七项已发表和八项未发表的试验（我们能够从其中一项获得数据）。症状学数据是从涉及 274 名参与者的六项试验中提取的。汇总效应大小（Hedge' s G) 总体症状很小且不显着 (-0.21, 95% CI -0.60-0.18)。试验通常被评为具有高偏倚风险。纳入试验的安全性报告不充分。结论 我们观察到的效应量与之前的荟萃分析中报告的形成对比。差异可能是由数据提取中的错误造成的。本综述的结果表明，目前没有足够的证据得出结论认为 ACT 是一种针对精神病症状的安全有效的治疗方法。系统评价注册：CRD42018097200。结论 我们观察到的效应量与之前的荟萃分析中报告的形成对比。差异可能是由数据提取中的错误造成的。本综述的结果表明，目前没有足够的证据得出结论认为 ACT 是一种针对精神病症状的安全有效的治疗方法。系统评价注册：CRD42018097200。结论 我们观察到的效应量与之前的荟萃分析中报告的形成对比。差异可能是由数据提取中的错误造成的。本综述的结果表明，目前没有足够的证据得出结论认为 ACT 是一种针对精神病症状的安全有效的治疗方法。系统评价注册：CRD42018097200。