Controlled studies of the Soteria paradigm were eligible for inclusion provided they included adults or adolescents diagnosed with schizophrenia, schizotypal or delusional disorders by International Classification of Diseases, 10th Revision (ICD-10) criteria or with schizophrenia spectrum disorders by Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria. The Soteria core principles were defined as: provision of a small therapeutic community with a high level of lay-person staffing; efforts to preserve personal power, social networks and group responsibilities; a phenomenological approach aiming to understand and give meaning to the subjective experience of psychosis; and no or minimal use of antipsychotic drugs (with any drugs taken being by choice rather than coercion). Eligible programmes described themselves as Soteria communities, were linked to the original Soteria community, used the core therapeutic elements of the Soteria programme or were explicitly modelled on Soteria principles. Studies using the name Soteria but not adhering to these core therapeutic principles were excluded. There were no specific inclusion criteria with respect to outcomes.
Participants in included studies had a first episode of disorder or a single previous episode, with hospitalisation for no more than 30 days. They were aged from 15 to 35 years. One study excluded people with drug or alcohol dependency or who were non-compliant with treatment.
A large number of outcomes were reported in the included studies (for example, number and duration of readmissions to full time care, score on psychopathology scale, functional measures, relapse rate and average medication dose), measured at two year follow-up.
Two reviewers selected studies for inclusion independently.