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Efficacy of 12-step mutual-help groups other than Alcoholics Anonymous: a systematic review and meta-analysis

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Abstract

This paper offers a systematic review of quantitative and qualitative studies on the main twelve-step mutual-help (TSMH) groups (excluding Alcoholics Anonymous) and four meta-analyses exploring the correlation between (i) duration or involvement in TSMH groups and; (ii) severity of symptoms or quality of life. Systematic review was conducted following PRISMA guidelines. Searches of databases (MEDLINE, PsychInfo), a register (ClinicalTrials) and citations were conducted, from inception through November 01 2022. Fifty five articles were included (24 quantitative, 27 qualitative, 4 mixed-methods), corresponding to 47 distinctive studies. 68% of these studies were conducted in North America, 17% in Middle East, 11% in the European Union and 4% in Australia. The most studied TSMH group were Gamblers Anonymous (28% of the 47 studies), Narcotics Anonymous (26%), Double Trouble in Recovery (15%), Overeaters Anonymous (19%) and TSMH groups for compulsive sexual behaviors (11%). The four meta-analyses pooled data from 9 studies. Pooled mean age ranged from 36.5 to 40.5. 80–81% of participants were male. TSMH attendance and involvement were negatively correlated with severity of symptoms (high and medium levels of evidence) and positively correlated with quality of life (low levels of evidence). Twenty-one qualitative papers reported factors influencing recovery: Social (n = 15), emotional (n = 9), spiritual (n = 8), self-identification or psychological (n = 6) factors. Review provides characteristics of TSMH groups others than Alcoholics Anonymous, with implications for both research and healthcare practice. The perspective to implement TSMH groups targeting ontological addiction, at the root of all addiction, is discussed.

Protocol registration: Prospero registration number: CRD42022342605.

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Funding

The study was supported by the Therapy Center for Mood and Emotional Disorders, Department of adult psychiatry, La Colombière, CHU Montpellier, France.

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Authors and Affiliations

  1. Lapeyronie Hospital, Montpellier, France

    Martin Leurent, Déborah Ducasse, Philippe Courtet & Emilie Olié

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  1. Martin Leurent
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  2. Déborah Ducasse
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  3. Philippe Courtet
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  4. Emilie Olié
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Contributions

ML drafted the manuscript, performed the data collection process, analyzed the risk of bias of all included papers and led the meta-analyses. DD evaluates the risk of bias of the 8 studies included in the meta-analysis. DD, PC and EO supervised ML throughout all the process by providing advises and feedbacks. All authors contributed critically to the text and all approved the final version of the manuscript.

Corresponding author

Correspondence to Déborah Ducasse.

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Conflict of interest

ML, DD, PC and EO declare no conflict of interest.

Appendices

Appendix A

See Table 5.

Table 5 Names of the 28 TSMH groups that were searched for inclusion in the databases presented in Sect. “Search strategy and selection criteria”. We used quotation marks so as to search for the exact expression in databases and register
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Appendix B

See Table 6.

Table 6 steps followed by major TSMH groups
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Appendix C

See Fig. 7.

Fig. 7
figure 7

Breakdown of face-to-face meetings by geographical area, for NA, OA and GA. Other kind of TSMH groups are not included in this figure as the required information was not available online

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Appendix D

See Table 7.

Table 7 Details on main TSMH groups
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Appendix E

See Tables 8 and 9.

Table 8 Scoring criteria for the quality assessment of individual quantitative studies
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Table 9 Quality assessment of individual quantitative studies
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Appendix F

See Tables 10, 11, 12 and 13.

Table 10 Measures used in the studies used to assess the pooled correlation severity of symptom and duration in TSMH, and pearson correlation (and corresponding p-value) between those two
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Table 11 Measures used in the studies used to assess the pooled correlation between severity of symptoms and duration in TSMH, and pearson correlation (and corresponding p-value) between those two
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Table 12 Measures used in the studies used to assess the pooled correlation between quality of life and duration in TSMH, and pearson correlation (and corresponding p-value) between those two
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Table 13 Measures used in the studies used to assess the pooled correlation between quality of life and TSMH involvement, and pearson correlation (and corresponding p-value) between those two
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Leurent, M., Ducasse, D., Courtet, P. et al. Efficacy of 12-step mutual-help groups other than Alcoholics Anonymous: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 274, 375–422 (2024). https://doi.org/10.1007/s00406-023-01667-x

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