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Journal of Affective Disorders Aug 2023Although insulin resistance (IR) and cardiometabolic syndrome are prevalent in patients with bipolar disorder (BD), only a few studies have attempted to precisely assess... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although insulin resistance (IR) and cardiometabolic syndrome are prevalent in patients with bipolar disorder (BD), only a few studies have attempted to precisely assess the degree and clinical impact of IR in BD.
METHODS
A comprehensive search was conducted from multiple research databases through May 2022, following a pre-defined protocol (PROSPERO: CRD42022359259). We extracted neuroimaging, cognition, illness course, and treatment response findings from individuals with BD with evidence of IR compared with euglycemic BD individuals.
RESULTS
Of 1436 identified articles, 10 reports fulfilling inclusion criteria were included (n = 1183). BD patients with IR displayed worse composite verbal memory scores and worse executive function and exhibited smaller hippocampal volumes along with prefrontal neurochemical alterations compared to euglycemic BD patients. Fixed-effect meta-analysis revealed that BD patients with impaired glucose metabolism (IGM) were more likely to develop a chronic and rapid cycling course when compared with euglycemic BD patients (k = 2, OR = 2.96, 95 % CI 1.69-5.17, OR = 2.88, 95 % CI 1.59-5.21, p < 0.001, respectively), with a trend for significantly lower Global Assessment of Functioning scores (k = 5, MD = -4, 95 % CI -8.23-0.23, p = 0.06). BD patients with IGM displayed a higher rate of poor response to mood stabilizers when compared with euglycemic BD patients (k = 2, OR = 6.74, 95 % CI 1.04-43.54, p = 0.04).
LIMITATIONS
Cross-sectional design and small sample sizes of studies included limit the generalizability of results.
CONCLUSION
IR is associated with worse clinical outcomes of BD and inadequate treatment response. Implementing strategies to prevent and treat IR in BD is crucial to improve the prognosis of such a difficult-to-treat population.
Topics: Humans; Bipolar Disorder; Cross-Sectional Studies; Executive Function; Immunoglobulin M; Insulin Resistance; Insulin
PubMed: 37086806
DOI: 10.1016/j.jad.2023.04.068 -
Schizophrenia Research Mar 2017Patients with schizophrenia display abnormalities in pitch discrimination of non-verbal tones as revealed by the Tone-Matching Task (TMT). It may lead to deficits in... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Patients with schizophrenia display abnormalities in pitch discrimination of non-verbal tones as revealed by the Tone-Matching Task (TMT). It may lead to deficits in higher-order cognitive functions and clinical symptoms.
OBJECTIVES
We conducted a systematic review and meta-analysis pooling data about TMT score differences between patients with schizophrenia and healthy controls, to evaluate the deficit's effect size, and to develop reliable knowledge about pitch processing impairment and its pejorative impact.
METHOD
Relevant publications were identified by a systematic search of PubMed and EMBASE databases. Then, we excluded non-relevant studies for the meta-analysis. Effect size for percent of correct responses to the TMT was expressed as standardized mean difference (SMD).
RESULTS
Eighteen of 167 identified studies met eligibility criteria for review, of which 10 were included in the meta-analysis. Our meta-analysis showed that the effect size for the percent of correct response to the TMT between patients (N=371) and controls (N=342) was large: SMD=1.17 [95% CI: 0.926-1.418] (z-value=9.338 and p-value<0.001). Meta-analysis showed moderate heterogeneity between studies (Q(9)=17.22, p=0.04, I=47.74%). The relationship between tone-matching impairment and clinical symptoms of schizophrenia remains heterogeneous across studies. Some authors observed significant correlations between tone-matching performance and a number of higher-order cognitive abilities.
CONCLUSION
This review and meta-analysis highlights a large significant disturbance in tone-matching ability in patients as compared with controls. The study of basic auditory processing opens promising perspectives for pathophysiological modelling of the disorder and therapeutic issues.
Topics: Auditory Perceptual Disorders; Humans; Pitch Discrimination; Schizophrenia
PubMed: 27742161
DOI: 10.1016/j.schres.2016.10.009 -
International Journal of Nursing Studies May 2021Forensic mental health is a challenging workplace, with nurses subject to various trauma exposures in their professional role. (Review)
Review
BACKGROUND
Forensic mental health is a challenging workplace, with nurses subject to various trauma exposures in their professional role.
OBJECTIVES
To identify the key concepts related to the nature, extent and impact of workplace trauma for forensic mental health nurses.
DESIGN
A scoping review, informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) tool.
METHODS
Sources of evidence were identified and assessed for inclusion using an explicit search strategy. Relevant information was extracted and synthesised to present a descriptive summary of existing evidence.
RESULTS
Of the 16 articles on workplace trauma for forensic mental health nurses included in the review, nine reported data related to extent (incidence and severity) and 14 described the impact. The incidence (per bed/per year) of each workplace trauma type ranged from 0.95 - 7.15 for physical violence, 0.39-5.12 for verbal abuse, 0.03-0.12 for sexual violence, and 1.47-7.9 for self-harming behaviour. The proportion of incidents at the lowest severity rating ranged from 15.1% to 84.7%, and the range for the highest severity rating was 0% to 38.7%. In the single study that examined the incidence of vicarious trauma, 14.9% reported low levels and 27.7% reported high levels. Psychological distress was the most commonly reported impact of workplace trauma, identified in eight studies. Seven studies reported limited data for physical injury from workplace trauma. The impacts of exposure to workplace trauma reported in the remaining studies included needing to access psychological support, experiencing physiological symptoms, feeling less safe at work, and requiring time off work. With the exception of two studies providing limited data related to absenteeism, the impact for organisations was not explored in existing literature.
CONCLUSIONS
While studies indicated that forensic mental health nurses are frequently exposed to various forms of workplace trauma, reports of severe assaults on staff were rare. Although limited, these findings suggest that cumulative exposure to workplace trauma over time, or exposure to more severe forms of physical violence, increase forensic mental health nurse vulnerability to experiencing detrimental impacts on their personal and professional wellbeing.
Topics: Aggression; Humans; Mental Health; Nurses; Psychiatric Nursing; Workplace
PubMed: 33647844
DOI: 10.1016/j.ijnurstu.2021.103897 -
European Journal of Orthodontics Feb 2023To assess the effect of clear aligners on the speech of patients undergoing orthodontic therapy through a systematic review of the literature. Search methods and... (Review)
Review
OBJECTIVE
To assess the effect of clear aligners on the speech of patients undergoing orthodontic therapy through a systematic review of the literature. Search methods and selection criteria: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694. An electronic search of the Scopus, Embase, Pubmed, and Web of Science databases was done for papers published between January 2000 till September 2021. Studies that evaluated speech difficulties in patients undergoing orthodontic treatment with clear aligners using objective and subjective analyses were included. The evaluated primary outcome was speech difficulties. Secondary outcomes were time to adaptation and recovery from speech difficulties. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions Handbook guidelines and ROBINS-I tool.
RESULTS
Two hundred and eighty-three articles were screened to identify seven studies (n = 332 patients) that assessed speech difficulty with aligners, of which two were randomized trials. Meta-analysis was not performed due to the heterogeneity in the study designs. Five studies compared speech difficulty with aligners to fixed appliances. Two studies showed a moderate risk of bias and five studies had a serious risk of bias. Level of evidence was downgraded to low due to the methodological insufficiencies and risk of bias in the studies. All seven studies reported that aligners could influence the clarity and delivery of speech, similar to fixed appliances. Various phonemes were affected including /s/,/z/,/zh/,/sh/,/th/,/ch/ on wearing aligners. Errors in articulation of consonants and sibilants were noted with lisping and speech impairment. These speech difficulties were temporary and most patients recovered in 7-14 days while few patients took 30-60 days to recover.
CONCLUSION
The likelihood of speech difficulties appears high with clear aligners. However, patients adapt quickly and speech returns to normal. The results of this review must be interpreted with caution and more well-designed randomized trials examining long-term effects of aligners on speech are indicated.
CLINICAL SIGNIFICANCE
Orthodontists should counsel patients opting for clear aligner treatment of the potential transient speech difficulties.
REGISTRATION
The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021278694.
Topics: Humans; Speech; Orthodontic Appliances, Fixed; Speech Disorders; Orthodontic Appliances, Removable
PubMed: 35522548
DOI: 10.1093/ejo/cjac018 -
Harvard Review of PsychiatryThe need for objective measurement in psychiatry has stimulated interest in alternative indicators of the presence and severity of illness. Speech may offer a source of...
The need for objective measurement in psychiatry has stimulated interest in alternative indicators of the presence and severity of illness. Speech may offer a source of information that bridges the subjective and objective in the assessment of mental disorders. We systematically reviewed the literature for articles exploring speech analysis for psychiatric applications. The utility of speech analysis depends on how accurately speech features represent clinical symptoms within and across disorders. We identified four domains of the application of speech analysis in the literature: diagnostic classification, assessment of illness severity, prediction of onset of illness, and prognosis and treatment outcomes. We discuss the findings in each of these domains, with a focus on how types of speech features characterize different aspects of psychopathology. Models that bring together multiple speech features can distinguish speakers with psychiatric disorders from healthy controls with high accuracy. Differentiating between types of mental disorders and symptom dimensions are more complex problems that expose the transdiagnostic nature of speech features. Convergent progress in speech research and computer sciences opens avenues for implementing speech analysis to enhance objectivity of assessment in clinical practice. Application of speech analysis will need to address issues of ethics and equity, including the potential to perpetuate discriminatory bias through models that learn from clinical assessment data. Methods that mitigate bias are available and should play a key role in the implementation of speech analysis.
Topics: Humans; Speech; Mental Disorders; Psychopathology; Psychiatry
PubMed: 36608078
DOI: 10.1097/HRP.0000000000000356 -
Psychological Bulletin Apr 2021The present meta-analysis aimed to quantify sex differences in verbal working memory and to examine potential moderators of these differences. We examined 802 effect... (Meta-Analysis)
Meta-Analysis
The present meta-analysis aimed to quantify sex differences in verbal working memory and to examine potential moderators of these differences. We examined 802 effect sizes from 478 samples in 284 studies in a multilevel meta-analysis. Results revealed a small overall female advantage (g = .028, 95% CI [.006, .050]). In the overall sample, results showed that sex differences differed across tasks. Specifically, the female advantage was significant for cued tasks (g = .079, 95% CI [.030, .128]) and Free Recall tasks (g = .145, 95% CI [.102, .188]) whereas there was a male advantage on Complex Span (g = -.042, 95% CI [-.083, -.002]), and no sex differences on Serial Recall (g = .003, 95% CI [-.055, .050]), and Simple Span tasks (g < .001, 95% CI [-.034, .033]). Within each task, we found that recall direction, stimulus type, presentation format, response format, and age accounted for significant variance in at least 1 of the tasks. Analyses provided no evidence of a publication bias, although the female advantage varied as a function of sample source, whether the title made reference to sex, and whether authors had to be contacted to obtain relevant data. Results are discussed in terms of their implications for sex differences in episodic memory and in the context of clinical applications and theory building. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Cues; Humans; Language; Memory, Episodic; Memory, Short-Term; Mental Recall; Sex Characteristics; Verbal Behavior
PubMed: 34166005
DOI: 10.1037/bul0000320 -
The Cochrane Database of Systematic... Jul 2016Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the... (Review)
Review
BACKGROUND
Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the muscles used for speech. Resulting speech difficulties can range from mild, with slightly slurred articulation and breathy voice, to profound, with an inability to produce any recognisable words. Children with dysarthria are often prescribed communication aids to supplement their natural forms of communication. However, there is variation in practice regarding the provision of therapy focusing on voice and speech production. Descriptive studies have suggested that therapy may improve speech, but its effectiveness has not been evaluated.
OBJECTIVES
To assess whether any speech and language therapy intervention aimed at improving the speech of children with dysarthria is more effective in increasing children's speech intelligibility or communicative participation than no intervention at all , and to compare the efficacy of individual types of speech language therapy in improving the speech intelligibility or communicative participation of children with dysarthria.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015 , Issue 7 ), MEDLINE, EMBASE, CINAHL , LLBA, ERIC, PsychInfo, Web of Science, Scopus, UK National Research Register and Dissertation Abstracts up to July 2015, handsearched relevant journals published between 1980 and July 2015, and searched proceedings of relevant conferences between 1996 to 2015. We placed no restrictions on the language or setting of the studies. A previous version of this review considered studies published up to April 2009. In this update we searched for studies published from April 2009 to July 2015.
SELECTION CRITERIA
We considered randomised controlled trials and studies using quasi-experimental designs in which children were allocated to groups using non-random methods.
DATA COLLECTION AND ANALYSIS
One author (LP) conducted searches of all databases, journals and conference reports. All searches included a reliability check in which a second review author independently checked a random sample comprising 15% of all identified reports. We planned that two review authors would independently assess the quality and extract data from eligible studies.
MAIN RESULTS
No randomised controlled trials or group studies were identified.
AUTHORS' CONCLUSIONS
This review found no evidence from randomised trials of the effectiveness of speech and language therapy interventions to improve the speech of children with early acquired dysarthria. Rigorous, fully powered randomised controlled trials are needed to investigate if the positive changes in children's speech observed in phase I and phase II studies are generalisable to the population of children with early acquired dysarthria served by speech and language therapy services. Research should examine change in children's speech production and intelligibility. It must also investigate children's participation in social and educational activities, and their quality of life, as well as the cost and acceptability of interventions.
Topics: Age Factors; Child; Child, Preschool; Dysarthria; Humans; Speech Intelligibility; Speech Therapy
PubMed: 27428115
DOI: 10.1002/14651858.CD006937.pub3 -
World Neurosurgery Nov 2023Awake craniotomy is a unique method to prevent motor deficits during the resection of lesions located in or close to functional areas. We sought to study the outcomes of... (Review)
Review
BACKGROUND
Awake craniotomy is a unique method to prevent motor deficits during the resection of lesions located in or close to functional areas. We sought to study the outcomes of pediatric craniotomy on published studies.
METHODS
The search for articles was performed through multiple search engines: PubMed, Google Scholar, Web of Science, and Wiley. The following search terms were used for screening the titles and abstracts: "awake brain surgery" and "children" or "pediatrics," "awake craniotomy," and "children" or "pediatrics," "pediatrics awake craniotomy," "awake brain surgery pediatrics," and "tumors." On initial screening of the titles and abstracts, 54 articles were found. After a thorough review of the full texts of obtained articles and removing duplicates, 16 articles remained.
RESULTS
The mean age group was 12.23 years. There was a slight difference between genders who underwent awake craniotomy in the pediatric age group, 52.7% male and 47.3% for female. Tumor resection was the most common indication of the surgery. Almost half (47.9%) experienced complete recovery following the surgery. However, of those who had complicated recovery, 7.5% experienced a speech deficit.
CONCLUSIONS
This systematic review summarized that awake brain surgery can prevent significant motor and language deficits postoperatively in children after tumor resection as it is considered a feasible and safe procedure.
Topics: Humans; Male; Female; Child; Brain Neoplasms; Wakefulness; Monitoring, Intraoperative; Craniotomy; Speech; Brain Mapping
PubMed: 37595837
DOI: 10.1016/j.wneu.2023.08.040 -
Journal of Affective Disorders Mar 2018There is a significant cognitive heterogeneity in bipolar disorder (BD). The aim of this systematic review was to examine the potential distinctive neuropsychological of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
There is a significant cognitive heterogeneity in bipolar disorder (BD). The aim of this systematic review was to examine the potential distinctive neuropsychological of features of clinical subgroups of BD. A literature search investigating cognitive differences between potential subtypes of BD was conducted.
METHODS
It was possible to conduct a meta-analysis of studies investigating the relationship between cognitive deficits and subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)), subgroups based on history of psychosis (PBD and NPBD). The cognitive domains investigated in this meta-analysis included verbal memory, visual memory, processing speed, executive functions speed (EF-speed), EF-accuracy, attention, working memory, social cognition. Current meta-analysis included 48 reports and compared cognitive performances of 1211 BD-I and 836 BD-II patients. It also compared cognitive functioning in 1017 PBD and 744 NPBD patients.
RESULTS
Both history of psychosis (d = 0.19) and BD-I (d = 0.17) diagnosis were associated with modestly more pronounced global cognitive impairment. In specific domains, BD-I significantly underperformed BD-II in verbal memory, processing speed, EF-speed, EF-accuracy (d = 0.15-0.26). PBD was associated with significantly impaired cognition compared to NPBD in verbal memory, processing speed, EF-speed, EF-accuracy, working memory and social cognition (d = 0.12-0.28).
CONCLUSION
In BD, history of psychosis and full-manic episode are modestly associated with increased cognitive deficits. Neurocognitive differences between clinical subtypes of BD are quite subtle and are not distinctive. Furthermore, other factors reflecting differences in illness severity can explain observed between-group differences. Most of the cognitive heterogeneity in BD cannot be explained by proposed subtypes of BD.
Topics: Adult; Attention; Bipolar Disorder; Cognition; Cognition Disorders; Diagnostic and Statistical Manual of Mental Disorders; Executive Function; Female; Humans; Male; Memory, Short-Term; Neuropsychological Tests; Psychotic Disorders; Reaction Time; Social Behavior
PubMed: 29306692
DOI: 10.1016/j.jad.2017.12.057 -
American Journal of Alzheimer's Disease... 2023The Observable Well-being in Living with Dementia-Scale was developed to address conceptual and methodological issues in current observational scales for music therapy....
The Observable Well-being in Living with Dementia-Scale was developed to address conceptual and methodological issues in current observational scales for music therapy. Creative interventions may receive lowered scores, as existing instruments rely heavily on verbal behavior. Methods were (1) Systematic review of observational instruments: (2) field work with music therapy and sociable interactions to operationalize the items; (3) field testing assessing feasibility and preliminary psychometric properties; (4) focus groups with experts to investigate content validity; (5) final field test and revision. 2199 OWLS-ratings were conducted in 11 participants. Hypotheses of construct validity and responsiveness were supported (r = .33 -.65). Inter-rater reliability was good (84% agreement between coders, Cohen's Kappa = .82), and intra-rater reliability was excellent (98% agreement, Cohen's Kappa = .98). Focus groups with 8 experts supported the relevance of the items and suggested further refinements to increase comprehensiveness. The final field-tested OWLS showed improved inter-rater reliability and usability.
Topics: Humans; Dementia; Music Therapy; Psychometrics; Reproducibility of Results
PubMed: 37269060
DOI: 10.1177/15333175231171990