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Effects of Risperidone in Autistic Children and Young Adults: A Systematic Review and Meta-Analysis.Current Neuropharmacology 2021There are several studies investigating the effects of risperidone on autism, but many of these studies are contradictory or inconclusive. This systematic review and... (Meta-Analysis)
Meta-Analysis
There are several studies investigating the effects of risperidone on autism, but many of these studies are contradictory or inconclusive. This systematic review and meta-analysis investigated the effects of risperidone on five domains of the Aberrant Behaviour Checklist (ABC) scale on Autism Spectrum Disorder (ASD), as well as weight gain and waist circumference. The protocol for the present systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). For this study, we analysed articles (2,459), selecting them according to the PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). Although risperidone is effective for the treatment of lethargy and inadequate speech, concerns about the association between weight gain, waist circumference and risperidone require a need for evaluation of the risk-benefit ratio in its use. There was a significant association between weight gain, waist circumference and risperidone. In conclusion, it was possible to suggest the efficacy of risperidone for the treatment of lethargy and inadequate speech. Finally, we emphasize that the risk-benefit in its use should be evaluated (Protocol number CRD42019122316).
Topics: Adolescent; Antipsychotic Agents; Autistic Disorder; Child; Female; Humans; Male; Risperidone; Treatment Outcome; Weight Gain; Young Adult
PubMed: 32469700
DOI: 10.2174/1570159X18666200529151741 -
Journal of Clinical Medicine Apr 2019Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are alternative approaches to retrospective self-reports and face-to-face treatments,... (Review)
Review
Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are alternative approaches to retrospective self-reports and face-to-face treatments, and they make it possible to repeatedly assess patients in naturalistic settings and extend psychological support into real life. The increase in smartphone applications and the availability of low-cost wearable biosensors have further improved the potential of EMA and EMI, which, however, have not yet been applied in clinical practice. Here, we conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to explore the state of the art of technology-based EMA and EMI for major depressive disorder (MDD). A total of 33 articles were included (EMA = 26; EMI = 7). First, we provide a detailed analysis of the included studies from technical (sampling methods, duration, prompts), clinical (fields of application, adherence rates, dropouts, intervention effectiveness), and technological (adopted devices) perspectives. Then, we identify the advantages of using information and communications technologies (ICTs) to extend the potential of these approaches to the understanding, assessment, and intervention in depression. Furthermore, we point out the relevant issues that still need to be addressed within this field, and we discuss how EMA and EMI could benefit from the use of sensors and biosensors, along with recent advances in machine learning for affective modelling.
PubMed: 30959828
DOI: 10.3390/jcm8040465 -
Tropical Medicine and Infectious Disease Nov 2022The number of publications on the development of arthritic pain after CHIKV infection is increasing; however, there is still a gap in the pathophysiological mechanisms... (Review)
Review
The number of publications on the development of arthritic pain after CHIKV infection is increasing; however, there is still a gap in the pathophysiological mechanisms that explain these outcomes. In this review, we conducted a descriptive analysis of the findings of patients to understand their prognosis and to explore therapeutic options. Here, we searched the Cochrane, BVS, PubMed, and Scielo databases using the keywords "arthritis", "pain", "arbovirus", "disease", "arthritogenic", and "arthralgia" during the 2000 to 2022 period. Descriptive analyses were conducted to understand the association between CHIKV infection and arthritogenic pain. The present study shows the persistence of acute phase signals for months, making the chronic phase still marked by the presence of arthralgia, often disabling under stimuli, such as temperature variation. CHIKV infection appears to be remarkably similar to rheumatoid arthritis, since both diseases share common symptoms. Once diagnosed, patients are mostly treated with analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease modifying anti-rheumatic drugs (DMARD). As there are no prophylactic measures or specific treatments for arboviruses, this study gathered information on the development and manifestations of arthritogenic pain.
PubMed: 36422941
DOI: 10.3390/tropicalmed7110390 -
Psychoneuroendocrinology Dec 2023The underlying psychobiology that contributes to Anorexia Nervosa (AN) onset and disease progression remains unclear. New research is emerging suggesting a possible link...
INTRODUCTION
The underlying psychobiology that contributes to Anorexia Nervosa (AN) onset and disease progression remains unclear. New research is emerging suggesting a possible link between inflammation and a variety of mental illnesses. Alterations of cytokines may play a role in the pathogenesis of AN. Some studies have found differences in the cytokine profile of those with AN compared to healthy controls, but results are heterogeneous. The aim of this work was to systematically review existing studies investigating in-vivo cytokine production in those with AN before and after weight restoration compared to controls.
METHODS
A comprehensive literature search of four electronic databases (PubMed, PsychInfo, EMBASE and CINAH) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify human in-vivo studies investigating the relationship between AN and cytokine production. Data extracted from included studies related to population characteristics (e.g. age, gender, mean mBMI/%IBW), cytokine measurement and relevant findings. Confounding factors (e.g. smoking status, co-morbid mental illness, menstruation status) were also collected.
RESULTS
36 studies were eligible for this systematic review of which the majority were conducted in Europe (77.8%) and involved female subjects (97.2%). Those with AN ranged in age from 13 to 47 years and had an illness duration of 3 months to 24 years. 15 candidate cytokines and 3 receptors were identified (TNF-alpha, IL-6, IL-1B, CRP, IL-2, IL-7, IL-10, IFN-γ, TNF-R2, IL-1 α, IL-15, TNF-R1, IL-17, IL-18, TGF-B1, IL-12, IL-6R and TGF-B2) exploring in-vivo levels in patients with AN and comparing to controls. TNF-alpha and IL-6 were the most extensively studied with IL-6 being significantly elevated in 4 out of 8 (50%) of longitudinal studies when comparing AN patients at baseline compared to post weight restoration. Following weight restoration, there was no difference in IL-6 levels when comparing to HC in 7 of 8 (87.5%) longitudinal studies examined.
CONCLUSIONS
The most promising cytokine potentially involved in the pathogenesis of AN appears to be IL-6, and possibly TNF-alpha pathways. The heterogeneity of clinical and methodology factors impedes the generalizability of results. Future studies may wish to address these methodological shortcomings as alterations in cytokine levels in AN could act as therapeutic targets assisting with weight restoration and psychopathology and may offer diagnostic potential.
Topics: Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Anorexia Nervosa; Tumor Necrosis Factor-alpha; Interleukin-6; Cytokines; Longitudinal Studies
PubMed: 37769539
DOI: 10.1016/j.psyneuen.2023.106390 -
Clinical Psychology & Psychotherapy May 2022In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results... (Review)
Review
In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results of psychological treatments. In recent years, mindfulness-based interventions (MBIs) have shown to be effective at increasing empathy and therapeutic alliance and how this could affect the patients' symptomatology. In this study, we conducted a systematic review of the effectiveness of MBIs applied to psychotherapists to improve their empathy, the therapeutic alliance and the patients' symptomatology. Sixteen studies evaluating the impact of an MBI on some of these variables were identified, of which six included measures evaluated by the patients whose psychotherapists received the MBI. The risk of bias of the included studies was analysed following the methodological standards. We found very different designs and methodologies in the studies included in this review, with few of them including a control group. The results show a limited increase in empathy, measured by the psychotherapist, after an MBI. However, the results in therapeutic alliance are not conclusive, as well as the improvements in the perception of patients about their symptomatology. It is concluded that MBIs can have a beneficial effect on the psychotherapeutic practice, through the development of psychotherapists' empathy. Future research would require new studies with a higher methodological quality, and in which the effects of MBIs on empathy, therapeutic alliance and patients' symptomatology and the relationships between them are analyzed.
Topics: Empathy; Humans; Mindfulness; Psychotherapists; Psychotherapy; Therapeutic Alliance
PubMed: 34687581
DOI: 10.1002/cpp.2676 -
Maturitas Jul 2017Falls in the elderly represent a major health problem. The etiology of falls is usually multifactorial. Special attention should be paid on benzodiazepines (BZDs) since... (Review)
Review
Falls in the elderly represent a major health problem. The etiology of falls is usually multifactorial. Special attention should be paid on benzodiazepines (BZDs) since they are widely used by older adults. A literature search of the PUBMED and EMBASE databases from January 2007 to February 2017 was conducted using the MeSH terms "benzodiazepines", "elderly" and "falls" or "accidental falls". The systematic review was performed according to PRISMA criteria. Of the 27 references selected for full reading from 235 found, 15 were eliminated and 12 papers were selected for systematic review. Exposure to BZDs was associated with a higher risk of falls in older adults, which is consistent with the results reported in the literature and previous reviews and meta-analyses. BZDs increase the risk of falling when used either as monotherapy or in combined therapies. It is preferable to use short-acting BZDs, to avoid cumulative effects over time predisposing to falls. A high proportion of falls in older adults are related to the use of BZDs. They should be prescribed to older patients in accordance with current clinical guidelines and reviewed over time. BZDs should be prescribed as a short-term therapy and progressively withdrawn. Short-acting BZDs should be the treatment of choice.
Topics: Accidental Falls; Aged; Benzodiazepines; Humans
PubMed: 28539164
DOI: 10.1016/j.maturitas.2017.04.002 -
International Journal of Molecular... Dec 2016Depressive disorders appear relatively frequently in older patients, and therefore represent an important disease burden worldwide. Given the high levels of inflammatory... (Meta-Analysis)
Meta-Analysis Review
Depressive disorders appear relatively frequently in older patients, and therefore represent an important disease burden worldwide. Given the high levels of inflammatory parameters found in depressed elderly patients, the "inflammaging" hypothesis is gaining strength. In this systematic review, we summarize current evidence regarding the relationship between inflammatory parameters and late-life depression, with a unique focus on longitudinal studies to guarantee temporality. According to the data summarized in this review, the levels of some proinflammatory parameters-especially interleukin (IL)-8, IL-6, and tumor necrosis factor (TNF)-α-could serve as biomarkers for the future development of depressive symptoms in elderly patients. Proinflammatory cytokines seem to be associated with the future development of clinically significant depression, irrespective of baseline scores, thus indicating that inflammation temporally precedes and increases depression risk. As insufficient research has been conducted in this field, further prospective studies are clearly warranted.
Topics: Biomarkers; Cohort Studies; Depression; Humans; Inflammation
PubMed: 27918465
DOI: 10.3390/ijms17122022 -
Neuropsychologia Nov 2014Social Anxiety Disorder (SAD) and Williams-Beuren Syndrome (WS) are two conditions which seem to be at opposite ends in the continuum of social fear but show compromised... (Meta-Analysis)
Meta-Analysis Review
Common and distinct neural correlates of facial emotion processing in social anxiety disorder and Williams syndrome: A systematic review and voxel-based meta-analysis of functional resonance imaging studies.
BACKGROUND
Social Anxiety Disorder (SAD) and Williams-Beuren Syndrome (WS) are two conditions which seem to be at opposite ends in the continuum of social fear but show compromised abilities in some overlapping areas, including some social interactions, gaze contact and processing of facial emotional cues. The increase in the number of neuroimaging studies has greatly expanded our knowledge of the neural bases of facial emotion processing in both conditions. However, to date, SAD and WS have not been compared.
METHODS
We conducted a systematic review of functional magnetic resonance imaging (fMRI) studies comparing SAD and WS cases to healthy control participants (HC) using facial emotion processing paradigms. Two researchers conducted comprehensive PubMed/Medline searches to identify all fMRI studies of facial emotion processing in SAD and WS. The following search key-words were used: "emotion processing"; "facial emotion"; "social anxiety"; "social phobia"; "Williams syndrome"; "neuroimaging"; "functional magnetic resonance"; "fMRI" and their combinations, as well as terms specifying individual facial emotions. We extracted spatial coordinates from each study and conducted two separate voxel-wise activation likelihood estimation meta-analyses, one for SAD and one for WS.
RESULTS
Twenty-two studies met the inclusion criteria: 17 studies of SAD and five of WS. We found evidence for both common and distinct patterns of neural activation. Limbic engagement was common to SAD and WS during facial emotion processing, although we observed opposite patterns of activation for each disorder. Compared to HC, SAD cases showed hyperactivation of the amygdala, the parahippocampal gyrus and the globus pallidus. Compared to controls, participants with WS showed hypoactivation of these regions. Differential activation in a number of regions specific to either condition was also identified: SAD cases exhibited greater activation of the insula, putamen, the superior temporal gyrus, medial frontal regions and the cuneus, while WS subjects showed decreased activation in the inferior region of the parietal lobule.
CONCLUSIONS
The identification of limbic structures as a shared correlate and the patterns of activation observed for each condition may reflect the aberrant patterns of facial emotion processing that the two conditions share, and may contribute to explaining part of the underlying neural substrate of exaggerated/diminished fear responses to social cues that characterize SAD and WS respectively. We believe that insights from WS and the inclusion of this syndrome as a control group in future experimental studies may improve our understanding of the neural correlates of social fear in general, and of SAD in particular.
Topics: Brain; Emotions; Facial Recognition; Humans; Magnetic Resonance Imaging; Phobia, Social
PubMed: 25194208
DOI: 10.1016/j.neuropsychologia.2014.08.027 -
Journal of Affective Disorders Jul 2021Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that...
BACKGROUND
Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs).
METHODS
A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019.
RESULTS
In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change.
LIMITATIONS
Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs.
CONCLUSIONS
Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.
Topics: Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Depression; Humans; Workplace
PubMed: 34082284
DOI: 10.1016/j.jad.2021.04.071 -
BMJ Open Sep 2016To examine the effectiveness of smoking cessation interventions in improving cessation rates and smoking related behaviour in patients with head and neck cancer (HNC). (Review)
Review
OBJECTIVE
To examine the effectiveness of smoking cessation interventions in improving cessation rates and smoking related behaviour in patients with head and neck cancer (HNC).
DESIGN
A systematic review of randomised and non-randomised controlled trials.
METHODS
We searched the following data sources: CENTRAL in the Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL up to February 2016. A search of reference lists of included studies and Google Scholar (first 200 citations published online between 2000 and February 2016) was also undertaken. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). 2 study authors independently screened and extracted data with disagreements resolved via consensus.
RESULTS
Of the 5167 studies identified, 3 were eligible and included in the review. Trial designs of included studies were 2 randomised controlled trials and 1 non-randomised controlled trial. 2 studies received a weak methodological rating and 1 received a moderate methodological rating. The trials examine the impact of the following interventions: (1) nurse delivered cognitive-behaviour therapy (CBT) via telephone and accompanied by a workbook, combined with pharmacotherapy; (2) nurse and physician brief advice to quit and information booklets combined with pharmacotherapy; and (3) surgeon delivered enhanced advice to quit smoking augmented by booster sessions. Only the trial of the nurse delivered CBT and pharmacotherapy reported significant increases in smoking cessation rates. 1 study measured quit attempts and the other assessed consumption of cigarettes per day and readiness to change. There was no significant improvement in quit attempts or cigarettes smoked per day among patients in the intervention groups, relative to control.
CONCLUSIONS
There are very few studies evaluating the effectiveness of smoking cessation interventions that report results specific to the HNC population. The 3 trials identified reported equivocal findings. Extended CBT counselling coupled with pharmacotherapy may be effective.
TRIAL REGISTRATION NUMBER
CRD42016016421.
Topics: Head and Neck Neoplasms; Health Promotion; Humans; Smoking Cessation; Tobacco Use Disorder; Treatment Outcome
PubMed: 27650767
DOI: 10.1136/bmjopen-2016-012296