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Breast (Edinburgh, Scotland) Apr 2022Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Psychoeducation has emerged as an intervention for women with breast cancer (BC). This meta-analysis evaluated the effectiveness of psychoeducation on adherence to diagnostic procedures and medical treatment, anxiety, depression, quality of life (QoL), and BC knowledge among patients with BC symptoms or diagnosis and BC survivors.
METHODS
A systematic literature search (in PubMed, Embase, PsycINFO and Cochrane) for randomised controlled trials (RCTs) comparing the effects of psychoeducation to control among patients with BC symptoms or diagnosis and BC survivors. Effects were expressed as relative risks (RRs) and standardized mean differences (SMDs) with their 95% confidence intervals.
RESULTS
Twenty-seven RCTs (7742 participants; 3880 psychoeducation and 3862 controls) were included. Compared with controls, psychoeducation had no significant effect on adherence to diagnostic procedures and medical treatment (RR 1.553; 95% CI 0.733 to 3.290, p = .16), but it significantly decreased anxiety (SMD -0.710, 95% CI -1.395 to -0.027, p = .04) and improved QoL with (SMD 0.509; 95% CI 0.096 to 0.923, p < .01). No effects were found for psychoeducation on depression (SMD -0.243, 95% CI -0.580 to 0.091, p = .14), or BC knowledge (SMD 0.718, 95% CI -0.800 to 2.236, p = .23).
CONCLUSION
We demonstrated that psychoeducation did not improve adherence to diagnostic procedures and treatment, depression and BC knowledge but was valuable for reducing anxiety and improving QoL. Future studies may explore the effectiveness of psychoeducation in promoting adherence across various types of cancer.
Topics: Anxiety; Breast Neoplasms; Depression; Female; Humans; Quality of Life; Survivors
PubMed: 35121502
DOI: 10.1016/j.breast.2022.01.005 -
European Child & Adolescent Psychiatry Feb 2024A better understanding of the endocannabinoid system and a relaxation in regulatory control of cannabis globally has increased interest in the medicinal use of... (Review)
Review
A better understanding of the endocannabinoid system and a relaxation in regulatory control of cannabis globally has increased interest in the medicinal use of cannabinoid-based products (CBP). We provide a systematic review of the rationale and current clinical trial evidence for CBP in the treatment of neuropsychiatric and neurodevelopmental disorders in children and adolescents. A systematic search of MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Trials was performed to identify articles published after 1980 about CBP for medical purposes in individuals aged 18 years or younger with selected neuropsychiatric or neurodevelopmental conditions. Risk of bias and quality of evidence was assessed for each article. Of 4466 articles screened, 18 were eligible for inclusion, addressing eight conditions (anxiety disorders (n = 1); autism spectrum disorder (n = 5); foetal alcohol spectrum disorder (n = 1); fragile X syndrome (n = 2); intellectual disability (n = 1); mood disorders (n = 2); post-traumatic stress disorder (n = 3); and Tourette syndrome (n = 3)). Only one randomised controlled trial (RCT) was identified. The remaining seventeen articles included one open-label trial, three uncontrolled before-and-after trials, two case series and 11 case reports, thus the risk of bias was high. Despite growing community and scientific interest, our systematic review identified limited and generally poor-quality evidence for the efficacy of CBP in neuropsychiatric and neurodevelopmental disorders in children and adolescents. Large rigorous RCTs are required to inform clinical care. In the meantime, clinicians must balance patient expectations with the limited evidence available.
Topics: Child; Humans; Adolescent; Cannabinoids; Anxiety Disorders; Stress Disorders, Post-Traumatic; Tourette Syndrome
PubMed: 36864363
DOI: 10.1007/s00787-023-02169-w -
Journal of Medical Internet Research May 2017Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal... (Review)
Review
BACKGROUND
Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.
OBJECTIVE
We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.
METHODS
Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes.
RESULTS
This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.
CONCLUSIONS
ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs' interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.
Topics: Communication; Humans; Psychology, Clinical; Telemedicine
PubMed: 28487267
DOI: 10.2196/jmir.6553 -
Neurotoxicology and Teratology 2022To summarize the available literature on long-term-development of children exposed to benzodiazepines in utero, through a systematic review. (Review)
Review
OBJECTIVE
To summarize the available literature on long-term-development of children exposed to benzodiazepines in utero, through a systematic review.
INFORMATION SOURCES
We conducted a systematic literature search of PubMed, PsycINFO and embase (1/9-2020 to 3/9-2020).
ELIGIBILITY CRITERIA
We included original studies with children older than one year prenatally exposed to BZ's and Z-hypnotics with outcomes regarding all psychological-, social-, motor- and neurodevelopmental disorders or disturbances of the children. Studies without a BZ-unexposed comparison group were excluded. Studies with only a single-dose exposure, conference abstracts, case reports and case series were excluded.
RISK OF BIAS
The intern validity of the included studies was assessed with the Newcastle Ottawa Scale tool (NOS).
INCLUDED STUDIES
13 cohort studies were included in this systematic review.
SYNTHESIS OF RESULTS
The outcomes investigated were internalizing and externalizing problems, language, hearing and communication skills, neurological outcomes and motor function, behavioral and emotional problems, social skills, intellect and academic achievements, psychiatric diagnoses and overall development. We found some evidence of higher risk of developing internalizing problems, impaired gross motor skills, lower academic achievements and increased ADHD-traits among children exposed to benzodiazepines in utero.
CONCLUSION
Prenatal exposure to benzodiazepines were associated with 4 developmental outcomes indicating an impaired long-term-development of the offspring. However, results were contradicting, and it cannot be ruled out, that findings might be due to bias. Furthermore, it remains uncertain if the results are of clinical relevance and whether developmental problems persist in later childhood. This study revealed a clear need for further research in the subject.
Topics: Benzodiazepines; Child; Child, Preschool; Cognitive Dysfunction; Cohort Studies; Female; Humans; Hypnotics and Sedatives; Pregnancy; Prenatal Exposure Delayed Effects
PubMed: 35189281
DOI: 10.1016/j.ntt.2022.107078 -
Autism Research : Official Journal of... Jun 2023The aim of this systematic review was to determine the efficacy of very early interventions for infants and toddlers at increased likelihood of or diagnosed with autism... (Meta-Analysis)
Meta-Analysis
Efficacy of very early interventions on neurodevelopmental outcomes for infants and toddlers at increased likelihood of or diagnosed with autism: A systematic review and meta-analysis.
The aim of this systematic review was to determine the efficacy of very early interventions for infants and toddlers at increased likelihood of or diagnosed with autism for autism symptomatology, developmental outcomes and/or neurocognitive markers. Eight databases were searched (14 April 2022) with inclusion criteria: (i) RCTs with care as usual (CAU) comparison group, (ii) participants at increased likelihood of or diagnosed with autism and aged <24 months corrected age (CA), (iii) parent-mediated and/or clinician directed interventions, and (iv) outcome measures were autism symptomatology, cognition, language, adaptive skills, or neurocognitive assessments (EEG and eye tracking). Quality was assessed using Risk of Bias 2 and GRADE. Nineteen publications from 12 studies reported on 715 infants and toddlers. There was low to moderate certainty evidence that clinician-assessed outcomes did not show significant treatment effects for: autism symptomatology (ADOS CSS: MD -0.08, 95% CI -0.61, 0.44, p = 0.75), cognitive outcome (Mullen Scales of Early Learning-Early Learning Composite (MSEL-ELC): SMD 0.05, 95% CI -0.19, 0.29, p = 0.67), receptive language (MSEL-Receptive Language: SMD 0.04, 95% CI -0.21, 0.3, p = 0.74) or expressive language (MSEL-Expressive Language: SMD 0.06, 95% CI -0.1, 0.23, p = 0.45). Neurocognitive outcomes (EEG and eye tracking) were heterogeneous, with inconsistent findings. There is low to moderate certainty evidence that very early interventions have limited impact on neurodevelopmental outcomes by age 3 years.
Topics: Humans; Infant; Child, Preschool; Autistic Disorder; Autism Spectrum Disorder; Parents; Language; Early Intervention, Educational
PubMed: 37036800
DOI: 10.1002/aur.2924 -
Psychiatric Services (Washington, D.C.) Apr 2022The experience of homelessness for young people can affect social, emotional, and physical development, resulting in poorer physical and mental health outcomes. To... (Review)
Review
OBJECTIVES
The experience of homelessness for young people can affect social, emotional, and physical development, resulting in poorer physical and mental health outcomes. To reduce rates of youth homelessness, a better understanding of both risk and resilience is needed to inform future intervention development. This article presents a systematic review of published research reporting risk or resilience factors related to homelessness among young people in Western countries.
METHODS
After thorough examination for inclusion criteria, 665 abstracts of peer-reviewed quantitative studies of risk or resilience factors for homelessness among young people (ages 0-25) that included an adequate comparison group (e.g., not homeless) were selected. After abstract and full-text screening, 16 articles were reviewed. A primary prevention framework was used to create an explanatory model for the onset of homelessness using risk and resilience factors.
RESULTS
Common risk factors for youth homelessness included difficulties with family, mental health or substance use problems, a history of problem behaviors, a history of foster care, homelessness as a child, and running away. Common protective factors included a supportive family, a college education, and high socioeconomic status. Findings were integrated into a provisional developmental model of youth homelessness risk. Clinical implications of the model for service development are discussed, and a model for monitoring homelessness risk and resilience factors is proposed.
CONCLUSIONS
Factors affecting homelessness risk among youths and adults differ, with family, foster care, and schooling playing a much more important role among youths. Findings highlight opportunities for youth homelessness prevention strategies and monitoring.
Topics: Adolescent; Adult; Child; Child, Preschool; Ill-Housed Persons; Homeless Youth; Humans; Infant; Infant, Newborn; Mental Health; Protective Factors; Risk Factors; Social Problems; Substance-Related Disorders; Young Adult
PubMed: 34320827
DOI: 10.1176/appi.ps.202000133 -
Clinical Psychology Review Aug 2021Individuals with schizophrenia-spectrum disorders face profound challenges as they attempt to maintain identity through the course of illness. Narrative identity-the... (Review)
Review
Individuals with schizophrenia-spectrum disorders face profound challenges as they attempt to maintain identity through the course of illness. Narrative identity-the study of internalized, evolving life stories-provides a rich theoretical and empirical perspective on these challenges. Based on evidence from a systematic review of narrative identity in the psychosis spectrum (30 studies, combined N = 3859), we argue that the narrative identities of individuals with schizophrenia-spectrum disorders are distinguished by three features: disjointed structure, a focus on suffering, and detached narration. Psychotic disorders typically begin to emerge during adolescence and emerging adulthood, which are formative developmental stages for narrative identity, so it is particularly informative to understand identity disturbances from a developmental perspective. We propose a developmental model in which a focus on suffering emerges in childhood; disjointed structure emerges in middle and late adolescence; and detached narration emerges before or around the time of a first psychotic episode. Further research with imminent risk and early course psychosis populations would be needed to test these predictions. The disrupted life stories of individuals on the psychosis spectrum provide multiple rich avenues for further research to understand narrative self-disturbances.
Topics: Adult; Humans; Narration; Psychotic Disorders; Schizophrenia
PubMed: 34274799
DOI: 10.1016/j.cpr.2021.102067 -
Transgender Health Feb 2022Research on transgender and gender expansive (TGE) youth has highlighted the disproportionate and challenging mental health and developmental outcomes faced by these... (Review)
Review
Research on transgender and gender expansive (TGE) youth has highlighted the disproportionate and challenging mental health and developmental outcomes faced by these young people. Research also largely suggests that family acceptance of TGE youth's gender identity and expression is crucial to preventing poor psychosocial outcomes in this community. Recently, family-based treatment has become common practice with TGE youth whose families are available for care, but it is unclear whether research provides outcome data for family interventions with TGE youth. This study follows Preferred Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically review articles that provide outcome data or clinical recommendations for family-based interventions with TGE youth and their families. No quantitative outcome data for family therapy with TGE youth were found, but numerous articles spanning decades (=32) provided clinical practice recommendations for family-based interventions with this population. Very few articles provided outcome data for family therapy with sexual minority youth (=2). Over time, clinical strategies have moved from pathologizing to affirming of TGE youths' gender journey. Common clinical strategies of affirming interventions include (1) providing psychoeducation, (2) allowing space for families to express reactions to their child's gender, (3) emphasizing the protective power of family acceptance, (4) utilizing multiple modalities of support, (5) giving families opportunities for allyship and advocacy, (6) connecting families to TGE community resources, and (7) centering intersectional approaches and concerns. Future research should examine the efficacy of family-based interventions that incorporate these clinical strategies and collect quantitative data to systematically determine their effect on psychosocial outcomes.
PubMed: 36644030
DOI: 10.1089/trgh.2020.0165 -
International Journal of Environmental... May 2022Evidence indicates shared physiopathological mechanisms between autism and psychosis. In this regard, the endocannabinoid system has been suggested to modulate neural... (Review)
Review
Evidence indicates shared physiopathological mechanisms between autism and psychosis. In this regard, the endocannabinoid system has been suggested to modulate neural circuits during the early stage of neurodevelopment, with implications for both autism and psychosis. Nevertheless, such potential common markers of disease have been investigated in both autism and psychosis spectrum disorders, without considering the conundrum of differentiating the two groups of conditions in terms of diagnosis and treatment. Here, we systematically review all human and animal studies examining the endocannabinoid system and its biobehavioral correlates in the association between autism and psychosis. Studies indicate overlapping biobehavioral aberrancies between autism and schizophrenia, subject to correction by modulation of the endocannabinoid system. In addition, common cannabinoid-based pharmacological strategies have been identified, exerting epigenetic effects across genes controlling neural mechanisms shared between autism and schizophrenia. Interestingly, a developmental and transgenerational trajectory between autism and schizophrenia is supported by evidence that exogenous alteration of the endocannabinoid system promotes progression to inheritable psychosis phenotypes in the context of biobehavioral autism vulnerability. However, evidence for a diametral association between autism and psychosis is scant. Several clinical implications follow from evidence of a developmental continuum between autism and psychosis as a function of the endocannabinoid system dysregulation.
Topics: Animals; Autistic Disorder; Cannabinoids; Endocannabinoids; Psychotic Disorders; Schizophrenia
PubMed: 35565034
DOI: 10.3390/ijerph19095616 -
PloS One 2016The primary aim of this paper is to conduct a thorough and systematic review of the empirical and practitioner research on executive, leadership and business coaching to... (Review)
Review
PURPOSE
The primary aim of this paper is to conduct a thorough and systematic review of the empirical and practitioner research on executive, leadership and business coaching to assess the current empirical evidence for the effectiveness of coaching and the mechanisms underlying it.
BACKGROUND
Organisations are increasingly using business coaching as an intervention to improve the productivity and performance of their senior personnel. A consequence of this increased application is the demand for empirical data to understand the process by which it operates and its demonstrable efficacy in achieving pre-set goals.
METHOD
This paper is a systematic review of the academic and practitioner literature pertaining to the effectiveness of business and executive coaching as a developmental intervention for organisations. It focuses on published articles, conference papers and theses that cover business, leadership or executive coaching within organisations over the last 10 years.
CONCLUSIONS
The main findings show that coaching is an effective tool that benefits organisations and a number of underlying facets contribute to this effectiveness. However, there is deficiency and scope for further investigation in key aspects of the academic research and we identify several areas that need further research and practitioner attention. .
Topics: Commerce; Humans; Leadership; Mentoring; Organizations; Psychology; Psychology, Industrial
PubMed: 27416061
DOI: 10.1371/journal.pone.0159137