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Journal of Eating Disorders Sep 2023According to case‒control studies, a multitude of factors contribute to the emergence of anorexia nervosa (AN). The present systematic review examines prospective... (Review)
Review
BACKGROUND
According to case‒control studies, a multitude of factors contribute to the emergence of anorexia nervosa (AN). The present systematic review examines prospective studies specifically designed to evaluate the prediction of AN onset.
METHODS
According to the ARMSTAR 2 and PRISMA 2020 checklists, the PubMed, PsycINFO and Cochrane databases were searched. The methodological quality of the studies was assessed with the Downs and Black checklist.
RESULTS
Three articles concerning prospective studies of the general population were ultimately included in the review. The methodological quality of these studies was not optimal. Bidirectional amplification effects were observed between risk factors, some of which could have a relative predictive force as low bodyweight or body dissatisfaction. Even if not included according to specified criteria for this systematic review 11 longitudinal studies, with retrospective analysis of AN onset' prediction, were also discussed. None of these studies asserted the predictive value of particular risk factors as low body weight, anxiety disorders or childhood aggression.
CONCLUSIONS
To date there are insufficient established data to propose predictive markers of AN onset for predictive actions in pre-adolescent or adolescent populations. Future work should further evaluate potential risk factors previously identified in case‒control/retrospective studies within larger prospective investigations in preadolescent populations. It is important to clearly distinguish predisposing factors from precipitating factors in subjects at risk of developing AN.
PubMed: 37730675
DOI: 10.1186/s40337-023-00882-0 -
Internal Medicine Journal Nov 2023To summarise the prognostic value of patient-reported outcomes (PROs) in advanced gastro-oesophageal (GO) cancer. We systematically searched multiple databases using... (Review)
Review
To summarise the prognostic value of patient-reported outcomes (PROs) in advanced gastro-oesophageal (GO) cancer. We systematically searched multiple databases using search terms related to advanced GO cancer, PRO and prognosis. Studies examining the relationship between baseline PROs and prognosis were included. Two reviewers independently screened articles and extracted data on study design, survival and associations between PROs and survival, in both univariable and multivariable analyses. QUIPS was used for quality assessment. From 3004 studies screened, seven studies were eligible, comprising PRO data from 2761 of 3408 (81%) participants. Median survival times ranged from 4.5 to 9.5 months. Among participants with oesophageal squamous cell carcinoma (SCC), physical functioning, social functioning and fatigue (QLQ-C30) were associated with overall survival (OS) in one univariable analysis. Among three studies of participants with adenocarcinoma, univariable analyses revealed associations between OS and global quality of life (QOL), physical functioning, role functioning and social functioning; two studies showed association with pain. There was an association between emotional functioning, fatigue, lack of mobility, lack of self-care, appetite loss/anorexia and OS in one study. One multivariable analysis among participants with oesophageal SCC showed physical and social functioning was associated with OS. Among participants with adenocarcinoma, multivariable analyses showed associations between OS and physical functioning/lack of mobility, appetite loss/anorexia (three studies), global QOL, role functioning/lack of self-care, pain (two studies) and social functioning (one study). Physical functioning, role functioning, social functioning, pain, anorexia and global QOL were associated with OS in advanced GO cancer.
Topics: Humans; Prognosis; Quality of Life; Anorexia; Stomach Neoplasms; Esophageal Neoplasms; Pain; Adenocarcinoma; Patient Reported Outcome Measures; Fatigue
PubMed: 37605848
DOI: 10.1111/imj.16209 -
Eating and Weight Disorders : EWD Apr 2024Several studies have investigated the association between anorexia nervosa and polymorphisms of genes regulating serotonin neurotransmission, with a focus on the rs6311... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Several studies have investigated the association between anorexia nervosa and polymorphisms of genes regulating serotonin neurotransmission, with a focus on the rs6311 polymorphism of 5-HTR2A. However, inconsistent results of these studies and conflicting conclusions of existing meta-analyses complicate the understanding of a possible association. We have updated these results and evaluated the involvement of other serotonin receptor gene polymorphisms in anorexia nervosa.
METHODS
Adhering to PRISMA guidelines, we have searched studies on anorexia nervosa and serotonin-regulating genes published from 1997 to 2022, selected those concerning receptor genes and meta-analyzed the results from twenty candidate gene studies on the 5-HTR2A rs6311 polymorphism and the 5-HTR2C rs6318 polymorphism.
RESULTS
Present analyses reveal an association for the 5-HTR2A rs6311 polymorphism, with G and A alleles, across eighteen studies (2049 patients, 2877 controls; A vs. G allele, Odds Ratio = 1.24; 95% Confidence Interval = 1.06-1.47; p = 0.009). However, after geographic subgrouping, an association emerged only in a Southern European area, involving five studies (722 patients, 773 controls; A vs. G allele, Odds Ratio = 1.82; 95% Confidence Interval = 1.41-2.37; p < 0.00001). No association was observed for the 5-HTR2C rs6318 polymorphism across three studies.
CONCLUSIONS
To date, the involvement in the pathophysiology of anorexia nervosa of the 5-HTR2A rs6311 polymorphism appears limited to a specific genetic and/or environmental context, while that of the 5-HTR2C rs6318 polymorphism seems excluded. Genome-wide association studies and epigenetic studies will likely offer deeper insights of genetic and environmental factors possibly contributing to the disorder.
LEVEL OF EVIDENCE
III Evidence obtained from well-designed cohort or case-control analytic studies. Clinical trial registration PROSPERO registration number: CRD42021246122.
Topics: Humans; Anorexia Nervosa; Genetic Predisposition to Disease; Polymorphism, Single Nucleotide; Receptor, Serotonin, 5-HT2A; Receptor, Serotonin, 5-HT2C
PubMed: 38668826
DOI: 10.1007/s40519-024-01659-3 -
Clinical Psychology & Psychotherapy 2024Decades of research implicate perfectionism as a risk factor for psychopathology. Most research has focused on trait perfectionism (i.e., needing to be perfect), but... (Meta-Analysis)
Meta-Analysis
Decades of research implicate perfectionism as a risk factor for psychopathology. Most research has focused on trait perfectionism (i.e., needing to be perfect), but there is a growing focus on perfectionistic self-presentation (PSP) (i.e., the need to seem perfect). The current article reports the results of a meta-analysis of previous research on the facets of PSP and psychopathology outcomes (either clinical diagnoses of psychiatric disorders or symptoms of these disorders). A systematic literature search retrieved 30 relevant studies (37 samples; N = 15,072), resulting in 192 individual effect-size indexes that were analysed with random-effect meta-analysis. Findings support the notion of PSP as a transdiagnostic factor by showing that PSP facets are associated with various forms of psychopathology, especially social anxiety, depression, vulnerable narcissism and-to lesser extent-grandiose narcissism and anorexia nervosa. The results indicated that there both commonalities across the three PSP and some unique findings highlighting the need to distinguish among appearing perfect, avoiding seeming imperfect and avoiding disclosures of imperfections. Additional analyses yielded little evidence in the results across studies including undergraduates, community samples and clinical samples. Our discussion includes a focus on factors and processes that contribute to the association between PSP and psychopathology.
Topics: Humans; Mood Disorders; Narcissism; Perfectionism; Psychopathology
PubMed: 38600830
DOI: 10.1002/cpp.2966 -
The American Surgeon May 2024Epiploic appendagitis (EA) is an essential cause of abdominal pain that can be confused with more typical causes such as acute diverticulitis and appendicitis. Epiploic... (Review)
Review
Epiploic appendagitis (EA) is an essential cause of abdominal pain that can be confused with more typical causes such as acute diverticulitis and appendicitis. Epiploic appendagitis accounts for 1% of all cases of abdominal pain in adults. The scarcity of information has limited its recognition as an essential nonsurgical cause of acute abdominal pain. We performed a systematic review of all EA cases published. We searched Scopus, Medline, Web of Science, and Google Scholar to retrieve all available studies from January 2000 to November 2023. 196 case reports and case series were analyzed, with 371 patients with EA included. The mean age at the time of diagnosis was 39 years. Most patients were male (59%). The primary presenting symptoms were pain (100%), tenderness (59.5%), and rebound tenderness (27.4%). The left abdomen was the most common localization of pain (53%). The most frequently identified differential diagnoses were acute appendicitis (26.4%) and acute diverticulitis (16.1%). Most patients (53%) were treated conservatively, and 98 (26.4%) underwent surgical treatment. A significant difference in the choice of treatment was found for signs and symptoms such as rebound tenderness, nausea, anorexia, and diarrhea. Acute EA is an essential clinical condition of rare occurrence that might present a diagnostic challenge, as it can masquerade as another acute abdominal pain etiology. The optimal management of EA is conservative, so a higher recognition by surgeons and emergency physicians is essential to avoid unnecessary surgical interventions and their associated consequences.
PubMed: 38756087
DOI: 10.1177/00031348241256062 -
Radiology and Oncology Dec 2023The outcome of systemic therapy (ST) for unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) is poor. This study aims to further evaluate the efficacy and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The outcome of systemic therapy (ST) for unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) is poor. This study aims to further evaluate the efficacy and safety of locoregional therapy combined with systemic therapy (LRT + ST) compared with only ST in unresectable and metastatic iCCA by performing a systematic literature review and meta-analysis.
METHODS
A comprehensive search was performed in PubMed, Web of Science, EMBASE, and the Cochrane Library up to November 3, 2022. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).
RESULTS
Ten retrospective cohort studies with 3,791 unresectable or metastatic iCCA patients were enrolled in this study, including 1,120 who received ablation, arterially directed therapy (ADT), or external beam radiation therapy (EBRT) combined with ST. The meta-analysis showed that the LRT + ST group had a better OS ( = 0.51; =0.41-0.64; < 0.001), PFS ( = 0.40, = 0.22-0.71, = 0.002) and ORR ( = 1.68; = 1.17-2.42; = 0.005). Subgroup analysis showed that both ST combined with ADT ( = 0.42, = 0.31-0.56, < 0.001) and EBRT ( = 0.67, = 0.63-0.72, < 0.001) could improve OS. Neutropenia, thrombocytopenia, anemia, anorexia, and vomiting did not show significant differences between the groups (p value > 0.05).
CONCLUSIONS
Compared with only ST, LRT + ST improved survival outcomes for unresectable and metastatic iCCA patients without increasing severe AEs, which can further provide a basis for guidelines.
Topics: Humans; Retrospective Studies; Cholangiocarcinoma; Progression-Free Survival; Bile Duct Neoplasms; Bile Ducts, Intrahepatic
PubMed: 38038416
DOI: 10.2478/raon-2023-0059 -
The International Journal of Eating... Feb 2024This study aimed to quantify the prevalence of non-suicidal self-injury across eating disorders (EDs) and within diagnostic categories through systematic review and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to quantify the prevalence of non-suicidal self-injury across eating disorders (EDs) and within diagnostic categories through systematic review and proportional, or so-called prevalence, meta-analysis.
METHOD
Included studies had to contain individuals with a verified diagnosis of an ED. The last literature search was conducted on September 11, 2023, for studies published on or before September 2023 without a restriction on earliest publication year. Results were synthesized and analyzed using the "metaprop" package in R and presented using forest plots. Bias was assessed by a Peters' regression test and funnel plot.
RESULTS
79 studies published between 1985 and 2023 were included encompassing 32,334 individuals with an ED. Importantly, 42 studies were not included in any other meta-analyses on self-injury in EDs to date. Overall prevalence of non-suicidal self-injury was 34.59% (95%CI = 30.49-38.81). Prevalence in anorexia nervosa restrictive type, binge/purge type, bulimia nervosa, binge eating disorder and other specified feeding/eating disorder were 23.19% (95%CI = 16.96-30.03%), 41.98% (95%CI = 32.35-51.91%), 36.97% (95%CI = 30.69-43.46%), 21.21% (95%CI = 14.93-28.12%) and 37.65% (95%CI = 28.59-47.09%), respectively. Prevalence estimations could not be estimated for other ED categories due to lack of a sufficient number of studies.
DISCUSSION
Non-suicidal self-injury is prevalent across both binge/purge and restrictive EDs. Considering the transdiagnostic nature of self-injurious behaviors in ED, the results highlight the importance of assessment and monitoring of self-injury in people with ED, irrespective of specific diagnoses. The method of determining self-injury varied across studies and may limit this study.
PUBLIC SIGNIFICANCE
This study highlights the prevalence of self-injury across eating disorders irrespective of diagnosis and within specific EDs. While diagnoses known to exhibit self-injurious behaviors (e.g., bulimia nervosa, anorexia nervosa binge/purge subtype) demonstrated the highest prevalence of self-injury, all diagnoses were found to have a prevalence greater than 20%. These findings suggest the importance of assessing and monitoring all individuals with an eating disorder for the presence of self-injury.
Topics: Humans; Prevalence; Feeding and Eating Disorders; Bulimia Nervosa; Binge-Eating Disorder; Self-Injurious Behavior; Anorexia Nervosa
PubMed: 38041221
DOI: 10.1002/eat.24088 -
Complementary Therapies in Medicine Nov 2023The purpose of this study was to assess the efficacy and safety of acupuncture at Sifeng for pediatric anorexia. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The purpose of this study was to assess the efficacy and safety of acupuncture at Sifeng for pediatric anorexia.
METHODS
The randomized controlled trials (RCTs) of acupuncture at Sifeng for pediatric anorexia from their beginning to October 2022 were looked up in the seven databases. The Cochrane risk of bias evaluation tool was applied to the risk of bias analysis of the included studies. A meta-analysis of the total efficiency, score of food intake reduction, time to normalize food intake, body weight, leptin levels, and blood zinc levels was performed using Review Manager 5.3 software. The GRADE criteria were applied to assess the evidence's quality.
RESULTS
A total of 24 RCTs were included, involving 2202 children. The allocation of concealment, blinding, and selective reporting has a high or unclear risk of bias. All experiments compared acupuncture at Sifeng with traditional Chinese medicine or Western medicine. The results showed that, compared with medicine, acupuncture at Sifeng could significantly improve the total efficiency (OR=6.44, 95%CI [4.78,8.66]), lower the score of food intake reduction (MD=-0.69, 95%CI [-1.00, -0.39]), decrease leptin levels (MD=-5.19, 95%CI [-8.09, -2.29]) and time to normal food intake (MD=-2.22, 95%CI [-2.42, -2.01]), increase blood zinc (MD=0.79, 95%CI [0.21, 1.37]) and body weight (MD=1.28, 95%CI [0.85, 1.72]). Seven studies found that the treatment was safe both during and after. Based on the GRADE criteria, the quality of the evidence for the majority of indicators was extremely poor.
CONCLUSION
The low certainty of evidence suggested that acupuncture at Sifeng was effective and safe in the therapy of pediatric anorexia. Future high-quality clinical studies are needed to provide more reliable evidence of the effectiveness and safety of the therapy.
Topics: Humans; Child; Anorexia; Leptin; Acupuncture Therapy; Zinc; Body Weight
PubMed: 37748564
DOI: 10.1016/j.ctim.2023.102988 -
Comprehensive Psychiatry May 2024Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging... (Review)
Review
Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging approach has been proposed. This systematic scoping review is aimed at mapping the existing staging models that explicitly propose stages of the progression of ED. A systematic search of PubMed, PsycINFO, Scopus was conducted with the terms staging, anorexia nervosa, bulimia nervosa, binge-eating disorders, eating disorders. Eleven studies met inclusion criteria presenting nine ED staging models, mostly for anorexia nervosa. Three were empirically tested, one of which was through an objective measure specifically developed to differentiate between stages. Most staging models featured early stages in which the exacerbation of EDs unfolds and acute phases are followed by chronic stages. Intermediate stages were not limited to acute stages, but also residual phases, remission, relapse, and recovery. The criteria for stage differentiation encompassed behavioral, psychological, cognitive, and physical features including body mass index and illness duration. One study recommended stage-oriented interventions. The current review underscores the need to empirically test the available staging models and to develop and test new proposals of staging models for other ED populations. The inclusion of criteria based on medical features and biomarkers is recommended. Staging models can potentially guide assessment and interventions in daily clinical settings.
Topics: Humans; Feeding and Eating Disorders; Bulimia Nervosa; Anorexia Nervosa; Binge-Eating Disorder; Body Mass Index
PubMed: 38460478
DOI: 10.1016/j.comppsych.2024.152468 -
Brain Sciences Jan 2024Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is an intervention specifically focused on addressing cognitive difficulties associated with the eating... (Review)
Review
BACKGROUND
Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is an intervention specifically focused on addressing cognitive difficulties associated with the eating disorder. This systematic review of systematic reviews and meta-analysis aimed to provide a summary of the existing literature examining the efficacy of CRT in improving the neuropsychological, psychological, and clinical parameters of patients with AN.
METHODS
Systematic reviews and meta-analyses were sought in electronic databases, encompassing studies that explored the impact of CRT on AN. Three eligible reviews were identified based on the inclusion criteria. The Revised Assessment of Multiple SysTemAtic Reviews (R-AMSTAR) was employed to evaluate the methodological quality of the reviews, and all included reviews demonstrated satisfactory methodological quality with an R-AMSTAR score of ≥22. Relevant information was extracted from each review and qualitatively compiled.
RESULTS
Findings suggest that CRT can help people increase their awareness of cognitive styles and information processing and have a positive effect on patients' responses to treatment.
CONCLUSIONS
Further research is required to better understand its impact on other relevant outcomes, including psychological variables, to optimize the treatment's benefits.
PubMed: 38391693
DOI: 10.3390/brainsci14020118