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American Journal of Clinical Dermatology Nov 2021Patients with vitiligo experience reduced quality of life.
BACKGROUND
Patients with vitiligo experience reduced quality of life.
OBJECTIVE
To comprehensively describe the available evidence for psychosocial burden in vitiligo.
METHODS
A systematic review of observational studies and clinical trials identified using PubMed, EMBASE, Scopus, and the Cochrane databases was performed through 1 March, 2021, to assess psychosocial comorbidities in vitiligo. Two independent reviewers performed an assessment of articles and extracted data for qualitative synthesis.
RESULTS
Included studies (N = 168) were published between 1979 and 1 March, 2021; 72.6% were published since 2010. Disorders including or related to depression (41 studies, 0.1-62.3%) and anxiety (20 studies, 1.9-67.9%) were the most commonly reported. The most prevalent psychosocial comorbidities were feelings of stigmatization (eight studies, 17.3-100%), adjustment disorders (12 studies, 4-93.9%), sleep disturbance (seven studies, 4.6-89.0%), relationship difficulties including sexual dysfunction (ten studies, 2.0-81.8%), and avoidance or restriction behavior (12.5-76%). The prevalence of most psychosocial comorbidities was significantly higher vs healthy individuals. Factors associated with a significantly higher burden included female sex, visible or genital lesions, age < 30 years (particularly adolescents), and greater body surface area involvement, among others. The most commonly reported patient coping strategy was lesion concealment.
LIMITATIONS
Available studies were heterogeneous and often had limited details; additionally, publication bias is possible.
CONCLUSIONS
The results of this systematic review show that vitiligo greatly affects psychosocial well-being. The extent of psychosocial comorbidities supports the use of multidisciplinary treatment strategies and education to address the vitiligo-associated burden of disease.
PROTOCOL REGISTRATION
PROSPERO (CRD42020162223).
Topics: Adaptation, Psychological; Adjustment Disorders; Age Factors; Body Surface Area; Clinical Trials as Topic; Comorbidity; Female; Humans; Male; Observational Studies as Topic; Personality Disorders; Prevalence; Quality of Life; Risk Factors; Severity of Illness Index; Social Stigma; Vitiligo
PubMed: 34554406
DOI: 10.1007/s40257-021-00631-6 -
Psychiatry Research Mar 2020Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify...
Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify risk factors that individuals can modify without professional intervention. A systematic review was conducted to identify studies that examined modifiable risk and protective factors for anxiety disorders among adults in the general population. Searches were conducted in PubMed, PsycINFO and MEDLINE using medical subject headings and text words related to risk factors, protective factors, and each anxiety disorder. Screening, data extraction, and quality assessment were performed by three study authors. Modifiable risk and protective factors from 19 studies across seven countries were identified. Risk factors identified included cigarette smoking, alcohol use, cannabis use, negative appraisals of life events, avoidance, and occupational factors. Protective factors included social support, coping, and physical activity. Cigarette smoking was the most studied risk factor. Support was found for cigarette smoking as a risk factor for agoraphobia and panic disorder. Mixed results were found for generalized anxiety disorder and specific phobia. Across disorders, smoking frequency was associated with greater risk. Results indicate an important gap in the literature in that few studies have examined modifiable risk factors for anxiety disorders.
Topics: Adult; Agoraphobia; Anxiety Disorders; Avoidance Learning; Cigarette Smoking; Cross-Sectional Studies; Female; Humans; Male; Occupational Health; Panic Disorder; Prevalence; Protective Factors; Retrospective Studies; Risk Factors; Substance-Related Disorders
PubMed: 31839417
DOI: 10.1016/j.psychres.2019.112705 -
International Journal of Environmental... Jul 2019Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital...
Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.
Topics: Delivery of Health Care; Humans; Patient Discharge; Patient Readmission
PubMed: 31295933
DOI: 10.3390/ijerph16142457 -
Journal of Behavioral Addictions Oct 2023Implicit cognitions may be involved in the development and maintenance of specific Internet use disorders such as problematic social network use (PSNU). In more detail,... (Review)
Review
Implicit cognitions may be involved in the development and maintenance of specific Internet use disorders such as problematic social network use (PSNU). In more detail, implicit attitude, attentional biases, approach and avoidance tendencies as well as semantic memory associations are considered relevant in the context of PSNU. This viewpoint article summarizes the available literature on implicit cognitions in PSNU. We systematically reviewed articles of implicit cognitions in PSNU from PubMed, Scopus, Web of Science, and ProQuest databases based on a targeted search strategy and assessed using predefined inclusion and exclusion criteria. The present findings suggest that specific implicit cognitions are important in the context of PSNU and therefore show parallels to other addictive behaviors. However, the empirical evidence is limited to a few studies on this topic. Implicit cognitions in PSNU should be explored in more depth and in the context of other affective and cognitive mechanisms in future work.
Topics: Humans; Cognition; Behavior, Addictive; Attentional Bias; Social Networking
PubMed: 37450371
DOI: 10.1556/2006.2023.00035 -
Journal of Neuro-oncology Jul 2023We systematically reviewed the current landscape of hippocampal-avoidance radiotherapy, focusing specifically on rates of hippocampal tumor recurrence and changes in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We systematically reviewed the current landscape of hippocampal-avoidance radiotherapy, focusing specifically on rates of hippocampal tumor recurrence and changes in neurocognitive function.
METHODS
PubMed was queried for studies involving hippocampal-avoidance radiation therapy and results were screened using PRISMA guidelines. Results were analyzed for median overall survival, progression-free survival, hippocampal relapse rates, and neurocognitive function testing.
RESULTS
Of 3709 search results, 19 articles were included and a total of 1611 patients analyzed. Of these studies, 7 were randomized controlled trials, 4 prospective cohort studies, and 8 retrospective cohort studies. All studies evaluated hippocampal-avoidance whole brain radiation treatment (WBRT) and/or prophylactic cranial irradiation (PCI) in patients with brain metastases. Hippocampal relapse rates were low (overall effect size = 0.04; 95% confidence interval [0.03, 0.05]) and there was no significant difference in risk of relapse between the five studies that compared HA-WBRT/HA-PCI and WBRT/PCI groups (risk difference = 0.01; 95% confidence interval [- 0.02, 0.03]; p = 0.63). 11 out of 19 studies included neurocognitive function testing. Significant differences were reported in overall cognitive function and memory and verbal learning 3-24 months post-RT. Differences in executive function were reported by one study, Brown et al., at 4 months. No studies reported differences in verbal fluency, visual learning, concentration, processing speed, and psychomotor speed at any timepoint.
CONCLUSION
Current studies in HA-WBRT/HA-PCI showed low hippocampal relapse or metastasis rates. Significant differences in neurocognitive testing were most prominent in overall cognitive function, memory, and verbal learning. Studies were hampered by loss to follow-up.
Topics: Humans; Prospective Studies; Retrospective Studies; Neoplasm Recurrence, Local; Cranial Irradiation; Brain Neoplasms; Hippocampus
PubMed: 37395975
DOI: 10.1007/s11060-023-04384-6 -
Behavioural Brain Research Aug 2023In clinical research, aberrant avoidance behavior and inhibitory control deficit have a high comorbidity in different psychopathological disorders. Therefore, avoidance... (Review)
Review
In clinical research, aberrant avoidance behavior and inhibitory control deficit have a high comorbidity in different psychopathological disorders. Therefore, avoidance and impulsive and/or compulsive behaviors might be classified as transdiagnostic traits, where the assessment through animal models could address evidence of their contribution as neurobehavioral mechanisms in psychopathology. The objective of the present review has been to assess the avoidance trait and the implication of inhibitory control behaviors, through studies using passive and active avoidance tests in rodents, and a preclinical model using selective breeding of high- or low-avoidance Roman rats (RHA, RLA). A systematic search strategy was carried out in the PubMed and Web of Science databases, where a total of 40 studies were accepted in the qualitative synthesis. The results of the different studies reviewed pointed to a relation between a reduced avoidance profile in passive avoidance (PA) with impulsive decision making and novelty-seeking behaviors; an increased avoidance profile in PA with compulsive drinking; a high active avoidance profile, including RHA rats, with different types of impulsivity and novelty- seeking behaviors; and regarding compulsivity depending on its measure, a low active avoidance profile, including RLA rats, has been associated with increased anxiety in the EPM and increased grooming, while a high active avoidance profile, including RHA rats, has been associated with increased rearing, compulsive drinking including alcohol, and cognitive inflexibility. The results have been discussed in terms of environmental factors and the underlying mechanisms between these possible transdiagnostic traits in psychopathology.
Topics: Rats; Animals; Avoidance Learning; Exploratory Behavior; Models, Animal; Phenotype; Ethanol; Behavior, Animal
PubMed: 37207979
DOI: 10.1016/j.bbr.2023.114500 -
Archives of Suicide Research : Official... 2020This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic...
This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic searches of several databases using combinations of the phrases "emotion regulation" AND "experiential avoidance" AND "self-harm," or "self-injury," and "BPD" or "Borderline Personality Disorder." Additional searches were conducted inclusive of terms related to experiential avoidance and emotion regulation, as well as other disorders related to self-harm. 17 articles were identified and reviewed. Results tentatively support the role of experiential avoidance in self-harm; some studies described phenomena similar to experiential avoidance without using the term. Poor emotion regulation was often cited as a reason for engagement in self-harm. Several gaps in the literature were identified and discussed.
Topics: Avoidance Learning; Borderline Personality Disorder; Emotional Regulation; Humans; Self-Injurious Behavior
PubMed: 30636566
DOI: 10.1080/13811118.2018.1563575 -
European Neuropsychopharmacology : the... Jul 2023The endocannabinoid system is a promising candidate for anxiolytic therapy, but translation to the clinic has been lagging. We meta-analyzed the evidence for... (Meta-Analysis)
Meta-Analysis Review
The endocannabinoid system is a promising candidate for anxiolytic therapy, but translation to the clinic has been lagging. We meta-analyzed the evidence for anxiety-reduction by compounds that facilitate endocannabinoid signaling in humans and animals. To identify areas of specific potential, effects of moderators were assessed. Literature was searched in Pubmed and Embase up to May 2021. A placebo/vehicle-control group was required and in human studies, randomization. We excluded studies that co-administered other substances. Risk of bias was assessed with SYRCLE's RoB tool and Cochrane RoB 2.0. We conducted three-level random effects meta-analyses and explored sources of heterogeneity using Bayesian regularized meta-regression (BRMA). The systematic review yielded 134 studies. We analyzed 120 studies (114 animal, 6 human) that investigated cannabidiol (CBD, 61), URB597 (39), PF-3845 (6) and AM404 (14). Pooled effects on conditioned and unconditioned anxiety in animals (with the exception of URB597 on unconditioned anxiety) and on experimentally induced anxiety in humans favored the investigational drugs over placebo/vehicle. Publication year was negatively associated with effects of CBD on unconditioned anxiety. Compared to approach avoidance tests, tests of repetitive-compulsive behavior were associated with larger effects of CBD and URB597, and the social interaction test with smaller effects of URB597. Larger effects of CBD on unconditioned anxiety were observed when anxiety pre-existed. Studies reported few side effects at therapeutic doses. The evidence quality was low with indications of publication bias. More clinical trials are needed to translate the overall positive results to clinical applications.
Topics: Animals; Humans; Anti-Anxiety Agents; Endocannabinoids; Bayes Theorem; Anxiety; Cannabidiol
PubMed: 37094409
DOI: 10.1016/j.euroneuro.2023.04.001 -
Brain Sciences May 2022There exist extensive animal research and lesion studies in humans demonstrating a tight association between the hypothalamus and socioemotional behavior. However, human... (Review)
Review
There exist extensive animal research and lesion studies in humans demonstrating a tight association between the hypothalamus and socioemotional behavior. However, human neuroimaging literature in this direction is still rather limited. In order to reexamine the functional role of this region in regulating human social behavior, we here provided a synthesis of neuroimaging studies showing hypothalamic activation during affiliative, cooperative interactions, and in relation to ticklish laughter and humor. In addition, studies reporting involvement of the hypothalamus during aggressive and antisocial interactions were also considered. Our systematic review revealed a growing number of investigations demonstrating that the evolutionary conserved hypothalamic neural circuity is involved in multiple and diverse aspects of human socioemotional behavior. On the basis of the observed heterogeneity of hypothalamus-mediated socioemotional responses, we concluded that the hypothalamus might play an extended functional role for species survival and preservation, ranging from exploratory and approaching behaviors promoting social interactions to aggressive and avoidance responses protecting and defending the established social bonds.
PubMed: 35741594
DOI: 10.3390/brainsci12060707 -
Supportive Care in Cancer : Official... Nov 2023Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels... (Review)
Review
PURPOSE
Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels of physical activity are often observed in this population. The aim of this systematic review is to gain insight into the barriers and facilitators to physical activity in cancer survivors afflicted with pain.
METHODS
In December 2021, a systematic search was conducted using PubMed and Web of Science. All studies exploring barriers and/or facilitators to physical activity in cancer survivors with pain were included. The methodological quality of the evidence was appraised with the Mixed Methods Appraisal Tool (version 2018).
RESULTS
Six articles were included. Current literature was limited and mostly focused on female breast cancer survivors. The identified barriers and facilitators could be categorized into six different domains: the logistical, symptoms, cognitive, clinical, social, and knowledge domain. The barrier of pain was reported as a barrier on its own that is closely linked to other barriers in this specific population.
CONCLUSION
Barriers and facilitators to physical activity were categorized in six different domains. The barrier of pain distinguishes itself and brings along additional obstacles such as anxiety, fear, and avoidance behavior. Current evidence is limited and focuses mostly on female breast cancer survivors. Further research in larger cohorts representing various subsets of cancer survivors with pain is warranted, as well as studies that implement these insights in physical activity interventions.
Topics: Humans; Female; Cancer Survivors; Exercise; Breast Neoplasms; Survivors; Pain
PubMed: 37922014
DOI: 10.1007/s00520-023-08141-3