This systematic review synthesized and appraised psychological interventions that measured changes in paranoia in adolescents (≤25 years old), searching 7 databases up to January 2026 and including 30 studies (10 RCTs, 13 single-arm studies, 7 case designs).
Most interventions were associated with improvements in paranoia, but few targeted paranoia as the primary outcome; CBT-based interventions showed the most promising effects across the 30 included studies.
- Weak methodological quality in many included studies limits confidence in conclusions. - Most interventions did not target paranoia as their primary outcome, making it hard to isolate specific effects. - Heavy reliance on single-arm and case designs (20 of 30 studies) reduces causal certainty.
CBT-based approaches appear most promising for reducing paranoia in adolescents, but dedicated, well-controlled trials are still lacking. Clinicians should prioritize early intervention while awaiting more rigorous evidence specific to this population.
