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    "doi": "10.1192\/j.eurpsy.2026.10158",
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    "title": "A systematic review of specialized psychosocial and complex psychosocial interventions for early psychosis, early depression, early bipolar disorder, and early borderline personality disorder",
    "authors": [
        "Andreas Bechdolf",
        "Hendrik Müller",
        "Daniel Richter",
        "Stefan Weinmann",
        "Thomas Becker",
        "Steffi G. Riedel-Heller",
        "Uta Gühne"
    ],
    "container": "European Psychiatry",
    "year": "2026",
    "doi_url": "https:\/\/doi.org\/10.1192\/j.eurpsy.2026.10158",
    "is_open_access": true,
    "oa_status": "gold",
    "best_landing_page": "https:\/\/pubmed.ncbi.nlm.nih.gov\/41787786",
    "best_pdf": "https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/A268199DC3B4F9CB65DCE074E15D1A36\/S0924933826101588a.pdf\/div-class-title-a-systematic-review-of-specialized-psychosocial-and-complex-psychosocial-interventions-for-early-psychosis-early-depression-early-bipolar-disorder-and-early-borderline-personality-disorder-div.pdf",
    "abstract": "BACKGROUND: This systematic review evaluates specialized psychosocial and complex interventions for early bipolar disorder (BD), early borderline personality disorder (BPD), early depression, early psychosis, and first-episode mental illness in general (FEMI). METHODS: We included systematic reviews and randomized controlled trials (RCTs) of interventions with psychosocial components, excluding trials that focused on pharmacological-only interventions and stand-alone psychotherapies. Searches were conducted in January 2023 across five databases. Review quality was assessed using AMSTAR-2 and risk of bias for RCTs using the Cochrane tool. RESULTS: Ten studies met the inclusion criteria: seven reviews and three RCTs. High-to moderate-quality evidence supports complex psychosocial interventions combined with pharmacotherapy for early psychosis. The most robust effects were reductions in relapse and improvements in psychosocial functioning; additional benefits were observed for symptom burden, remission, treatment discontinuation, and hospital admissions. Benefits were most sustained in longer-duration, community-based programs. For early BD, limited evidence suggests that combining pharmacotherapy with family-focused therapy or structured psychoeducation may improve the course of illness and treatment satisfaction. One RCT in early BPD reported improved engagement with a developmentally tailored program. Two FEMI RCTs found that nurse-led psychoeducation and psychosocial programs improved in-patient duration, symptoms, insight, self-efficacy, quality of life, and engagement. No eligible studies addressed early-stage depression, indicating a notable evidence gap for multimodal psychosocial interventions. CONCLUSIONS: Complex psychosocial interventions are strongly supported for early psychosis. Preliminary data in BD, BPD, and FEMI suggest consistent benefits for engagement, but further rigorous trials - especially in early depression - focusing on different outcomes - are required.",
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