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The American Journal of Occupational... 2020Sensory integration modalities, such as weighted blankets, are used in occupational therapy practice to assist with emotional and physical regulation. However, the...
IMPORTANCE
Sensory integration modalities, such as weighted blankets, are used in occupational therapy practice to assist with emotional and physical regulation. However, the research related to the use and effectiveness of weighted blankets is sparse.
OBJECTIVE
To identify, evaluate, and synthesize the current literature to help develop the impetus needed to launch a research study into the effectiveness of using weighted blankets to decrease anxiety and insomnia.
DATA SOURCES
A literature search was conducted between January 23, 2018, and March 1, 2018. Databases and sites included the Cochrane Library, PubMed, PsycINFO, CINAHL, OTseeker, Web of Science, and Nursing Reference Center Plus. Search terms included weighted blanket, deep pressure, and occupational therapy as well as combinations of these terms.
STUDY SELECTION AND DATA COLLECTION
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were included if the study used weighted blankets as the modality of deep pressure stimulation. Data from presentations, conference proceedings, non-peer-reviewed literature, dissertations, and theses were excluded.
FINDINGS
Only 8 studies were included: 4 Level I, 2 Level III, and 2 Level IV studies. The outcomes of these studies suggest that weighted blankets have the potential to be beneficial in limited settings and populations.
CONCLUSION AND RELEVANCE
Weighted blankets may be an appropriate therapeutic tool in reducing anxiety; however, there is not enough evidence to suggest they are helpful with insomnia.
WHAT THIS ARTICLE ADDS
Evidence-based research on the effectiveness of weighted blankets in reducing anxiety and insomnia is sparse. More research is needed to define guidelines for the use of weighted blankets in clinical practice and to investigate the underlying mechanism of action. This systematic review can be used to begin an investigation of the use of weighted blankets for larger and more diverse populations.
Topics: Anxiety; Bedding and Linens; Equipment Design; Humans; Occupational Therapy; Sleep Wake Disorders
PubMed: 32204779
DOI: 10.5014/ajot.2020.037358 -
The Lancet. Psychiatry Oct 2019Although many meta-analyses have examined the association between childhood sexual abuse and subsequent outcomes, the scope, validity, and quality of this evidence has...
BACKGROUND
Although many meta-analyses have examined the association between childhood sexual abuse and subsequent outcomes, the scope, validity, and quality of this evidence has not been comprehensively assessed. We aimed to systematically review existing meta-analyses on a wide range of long-term psychiatric, psychosocial, and physical health outcomes of childhood sexual abuse, and evaluate the quality of the literature.
METHODS
In this umbrella review, we searched four databases (PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, and Global Health) from inception to Dec 31, 2018, to identify meta-analyses of observational studies that examined the association between childhood sexual abuse (before 18 years of age) and long-term consequences (after 18 years). We compared odds ratios (ORs) across different outcomes. We also examined measures of quality, including heterogeneity between studies and evidence for publication bias. This study is registered with PROSPERO, CRD42016049701.
FINDINGS
We identified 19 meta-analyses that included 559 primary studies, covering 28 outcomes in 4 089 547 participants. Childhood sexual abuse was associated with 26 of 28 specific outcomes: specifically, six of eight adult psychiatric diagnoses (ORs ranged from 2·2 [95% CI 1·8-2·8] to 3·3 [2·2-4·8]), all studied negative psychosocial outcomes (ORs ranged from 1·2 [1·1-1·4] to 3·4 [2·3-4·8]), and all physical health conditions (ORs ranged from 1·4 [1·3-1·6] to 1·9 [1·4-2·8]). Strongest psychiatric associations with childhood sexual abuse were reported for conversion disorder (OR 3·3 [95% CI 2·2-4·8]), borderline personality disorder (2·9 [2·5-3·3]), anxiety (2·7 [2·5-2·8]), and depression (2·7 [2·4-3·0]). The systematic reviews for two psychiatric outcomes (post-traumatic stress disorder and schizophrenia) and one psychosocial outcome (substance misuse) met high quality standards. Quality was low for meta-analyses on borderline personality disorder and anxiety, and moderate for conversion disorder. Assuming causality, population attributable risk fractions for outcomes ranged from 1·7% (95% CI 0·7-3·3) for unprotected sexual intercourse to 14·4% (8·8-19·9) for conversion disorder.
INTERPRETATION
Although childhood sexual abuse was associated with a wide range of psychosocial and health outcomes, systematic reviews on only two psychiatric disorders (post-traumatic stress disorder and schizophrenia) and one psychosocial outcome (substance misuse) were of a high quality. Whether services should prioritise interventions that mitigate developing certain psychiatric disorders following childhood abuse requires further review. Higher-quality meta-analyses for specific outcomes and more empirical studies on the developmental pathways from childhood sexual abuse to later outcomes are necessary.
FUNDING
Wellcome Trust.
Topics: Child; Child Abuse, Sexual; Health Status; Humans; Mental Disorders
PubMed: 31519507
DOI: 10.1016/S2215-0366(19)30286-X -
Journal of Psychiatric and Mental... Aug 2022WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice... (Review)
Review
WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice that may result in negative outcomes for mental healthcare consumers. Compassion fatigue has clear emotional and physical costs and significant impacts on staff recruitment and retention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the first to evaluate the quantitative literature on compassion fatigue in mental health nurses. Research on compassion fatigue in mental health nurses does not accurately account for the unique care relationship between nurse and consumer. Competency-based education, strong mental health nurse leadership, positive organizational cultures, clinical supervision and reflection alongside individual self-care strategies may mitigate compassion fatigue. WHAT ARE THE IMPLICATIONS FOR FUTURE PRACTICE?: Resources are urgently needed for education and workforce development that addresses compassion fatigue in mental health nurses. Interventions addressing the physical, cognitive and emotional demands of care work are needed to ensure mental health nurses have the capability to provide sustainable compassionate care to consumers. ABSTRACT: Introduction Although compassionate care is an essential component of mental health nursing, understandings of the impact of compassion fatigue is poorly understood. Aims/Questions To examine and synthesize available data on the prevalence of compassion fatigue within mental health nurses and consider what variables impact compassion fatigue. Method A search of MEDLINE, EMBASE, PsychINFO, Emcare, Web of Science, Scopus, CINAHL and grey literature for articles published between 1992 and February 2021 was conducted. Data were extracted from articles meeting inclusion criteria and integrated using narrative synthesis. Results Twelve articles were included. Prevalence of compassion fatigue ranged from low to high. Variables were identified that may mitigate the risk of compassion fatigue. Strong leadership and positive workplace cultures, clinical supervision, reflection, self-care and personal well-being may protect mental health nurses against compassion fatigue. Discussion Future research is needed on mental health nurses lived experience of compassion fatigue and their understandings of compassion. Implications for Practice Interventions should focus on increasing awareness of compassion fatigue and building individual and organizational resilience. Both organizations and individuals should be aware of the role they play in maintaining the capacity and capability for mental health nurses to provide sustainable and compassionate mental healthcare.
Topics: Compassion Fatigue; Empathy; Humans; Mental Health; Nurses; Psychiatric Nursing; Staff Development; Workplace
PubMed: 34874593
DOI: 10.1111/jpm.12812 -
International Journal of Environmental... Dec 2022Eating disorders (EDs) are common among children and adolescents and are characterized by excessive concerns for physical appearance, distorted body image, and fear of... (Meta-Analysis)
Meta-Analysis Review
Eating disorders (EDs) are common among children and adolescents and are characterized by excessive concerns for physical appearance, distorted body image, and fear of gaining weight. The purpose of this review is to evaluate the follow-up of EDs from adolescence to adulthood, analyzing persistence, relapses, and associated comorbidities. We searched scientific articles in PubMed, PsycInfo, Scopus, and Embase through two research strings, one for quantitative outcomes (recovery/persistence, relapse, and remission) and one for the other outcomes (psychiatric and medical comorbidities, substance use, and social-relational complications). From a total of 8043 retrieved articles, we selected 503 papers after exclusion of duplicates and title/abstract screening. After a full-text evaluation, we included 16 studies eligible for this review. We performed a meta-analysis describing the quantitative results, and we created a narrative synthesis for the qualitative outcomes. Results: Our results confirm that EDs can persist in early adulthood in 40.7% of cases with a relapse percentage of 24.5%. Individuals with an ED more frequently present with an empathy deficit and comorbid anxiety and depressive disorders. EDs are chronic and complex disorders, more frequent in females. In most cases, EDs reduce the autonomy of individuals who present many difficulties in affirming their independence from parental family.
Topics: Adolescent; Female; Child; Humans; Adult; Feeding and Eating Disorders; Comorbidity; Anxiety Disorders; Substance-Related Disorders
PubMed: 36498309
DOI: 10.3390/ijerph192316237 -
International Journal of Environmental... Sep 2021Adherence to prescribed medication regimes improves outcomes for patients with severe mental illness such as schizophrenia or bipolar disorders. The aim of this... (Meta-Analysis)
Meta-Analysis Review
Adherence to prescribed medication regimes improves outcomes for patients with severe mental illness such as schizophrenia or bipolar disorders. The aim of this systematic review and meta-analysis was to compare the effectiveness among interventions to improve medication adherence in patients with schizophrenia or bipolar disorders. Literature published in the last decade was searched for interventions studies to improve adherence in patients with schizophrenia or a bipolar disorder. Interventions were categorised on the basis of type, and the context and effectiveness of the interventions were described. Two review authors independently extracted and assessed data, following criteria outlined by the Cochrane Handbook for Systematic Reviews of Interventions. The GRADEPro (McMaster University, 2020, Ontario, Canada) was used for assessing the quality of the evidence. Twenty-three publications met the selection criteria. Different types of interventions aiming to improve adherence were tested: educational, behavioural, family-based, technological, or a combination of previous types. Meta-analysis could be performed for 10 interventions. When considered separately by subgroups on the basis of intervention type, no significant differences were found in adherence among interventions ( = 0.29; I = 19.9%). This review concluded that successful interventions used a combination of behavioural and educational approaches that seem easy to implement in daily practice.
Topics: Bipolar Disorder; Humans; Medication Adherence; Ontario; Schizophrenia
PubMed: 34639510
DOI: 10.3390/ijerph181910213 -
Molecular Psychiatry Apr 2022The emerging understanding of gut microbiota as 'metabolic machinery' influencing many aspects of physiology has gained substantial attention in the field of psychiatry.... (Review)
Review
The emerging understanding of gut microbiota as 'metabolic machinery' influencing many aspects of physiology has gained substantial attention in the field of psychiatry. This is largely due to the many overlapping pathophysiological mechanisms associated with both the potential functionality of the gut microbiota and the biological mechanisms thought to be underpinning mental disorders. In this systematic review, we synthesised the current literature investigating differences in gut microbiota composition in people with the major psychiatric disorders, major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ), compared to 'healthy' controls. We also explored gut microbiota composition across disorders in an attempt to elucidate potential commonalities in the microbial signatures associated with these mental disorders. Following the PRISMA guidelines, databases were searched from inception through to December 2021. We identified 44 studies (including a total of 2510 psychiatric cases and 2407 controls) that met inclusion criteria, of which 24 investigated gut microbiota composition in MDD, seven investigated gut microbiota composition in BD, and 15 investigated gut microbiota composition in SZ. Our syntheses provide no strong evidence for a difference in the number or distribution (α-diversity) of bacteria in those with a mental disorder compared to controls. However, studies were relatively consistent in reporting differences in overall community composition (β-diversity) in people with and without mental disorders. Our syntheses also identified specific bacterial taxa commonly associated with mental disorders, including lower levels of bacterial genera that produce short-chain fatty acids (e.g. butyrate), higher levels of lactic acid-producing bacteria, and higher levels of bacteria associated with glutamate and GABA metabolism. We also observed substantial heterogeneity across studies with regards to methodologies and reporting. Further prospective and experimental research using new tools and robust guidelines hold promise for improving our understanding of the role of the gut microbiota in mental and brain health and the development of interventions based on modification of gut microbiota.
Topics: Bipolar Disorder; Brain; Depressive Disorder, Major; Gastrointestinal Microbiome; Humans; Schizophrenia
PubMed: 35194166
DOI: 10.1038/s41380-022-01456-3 -
Italian Journal of Pediatrics Jul 2022Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease's symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent.
METHODS
The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2).
RESULTS
A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4-1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1-1), 1% (95% CI: 0.8-1.1), 0.5% (95% CI: 0.2-1), 1% (95% CI: 0.3-3.1), 1.7% (95% CI: 0.5-6.1) respectively.
CONCLUSION
ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients' communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.
Topics: Autism Spectrum Disorder; Child, Preschool; Europe; Humans; Prevalence
PubMed: 35804408
DOI: 10.1186/s13052-022-01310-w -
International Journal of Nursing Studies Oct 2021Better understanding of patient and family member experiences of delirium and related distress during critical care is required to inform the development of targeted... (Review)
Review
BACKGROUND
Better understanding of patient and family member experiences of delirium and related distress during critical care is required to inform the development of targeted nonpharmacologic interventions.
OBJECTIVE
To examine and synthesize qualitative data on patient and family member delirium experiences and relieving factors in the Intensive Care Unit (ICU).
DESIGN
We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family quotes about delirium during critical care, published in English in a peer-reviewed journal since 1980. Data sources included PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane and Clinicaltrials.gov.
METHODS
Systematic searches yielded 3238 identified articles, of which 14 reporting 13 studies were included. Two reviewers independently extracted data into a Microsoft Excel spreadsheet. Qualitative meta-synthesis was performed through line-by-line coding of relevant quotes, organization of codes into descriptive themes, and development of analytical themes. Five patients/family members with experience of ICU delirium contributed to the thematic analysis.
RESULTS
Qualitative meta-synthesis resulted in four major themes and two sub-themes. Key new patient and family-centric insights regarding delirium-related distress in the ICU included articulation of the distinct emotions experienced during and after delirium (for patients, predominantly fear, anger and shame); its 'whole-person' nature; and the value that patients and family members placed on clinicians' compassion, communication, and connectedness.
CONCLUSIONS
Distinct difficult emotions and other forms of distress are experienced by patients and families during ICU delirium, during which patients and families highly value human kindness and empathy. Future studies should further explore and address the many facets of delirium-related distress during critical care using these insights and include patient-reported measures of the predominant difficult emotions.
Topics: Adult; Critical Care; Delirium; Family; Humans; Intensive Care Units; Patients; Qualitative Research
PubMed: 34343884
DOI: 10.1016/j.ijnurstu.2021.104030 -
International Journal of Environmental... Dec 2022This meta-analysis review compared eye movement desensitization and reprocessing and cognitive behavior therapy efficacy in reducing post-traumatic stress disorder... (Meta-Analysis)
Meta-Analysis Review
This meta-analysis review compared eye movement desensitization and reprocessing and cognitive behavior therapy efficacy in reducing post-traumatic stress disorder (PTSD), anxiety, and depression symptoms. A systematic search for articles published between 2010 and 2020 was conducted using five databases. The RevMan software version 5 was used. Out of 671 studies, 8 fulfilled the inclusion criteria and were included in this meta-analysis. Three studies reported that eye movement desensitization and reprocessing reduced depression symptoms better than cognitive behavior therapy in both children, adolescents, and adults (SDM (95% CI) = -2.43 (-3.93--0.94), = 0.001). In three other studies, eye movement desensitization and reprocessing were shown to reduce anxiety in children and adolescents better than cognitive behavior therapy (SDM (95% CI) = -3.99 (-5.47--2.52), < 0.001). In terms of reducing PTSD symptoms, eye movement desensitization and reprocessing and cognitive behavior therapy did not demonstrate any statistically significant differences (SDM (95% CI) = -0.14 (-0.48-0.21), = 0.44). There was no statistically significant difference at the three-month follow-up and at the six-month follow-up for depression ( = 0.31), anxiety ( = 0.59), and PTSD ( = 0.55). We recommend randomized trials with larger samples and longer follow-up times in the future.
Topics: Child; Adult; Adolescent; Humans; Stress Disorders, Post-Traumatic; Eye Movements; Cognitive Behavioral Therapy; Anxiety Disorders; Eye Movement Desensitization Reprocessing; Treatment Outcome
PubMed: 36554717
DOI: 10.3390/ijerph192416836 -
Annals of General Psychiatry Dec 2021Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric... (Review)
Review
BACKGROUND
Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric psychiatric disorders and a major risk factor for disability and mortality in elderly patients. Even though depression is a common mental health problem in the elderly population, it is undiagnosed in half of the cases. Several studies showed different and inconsistent prevalence rates in the world. Hence, this study aimed to fill the above gap by producing an average prevalence of depression and associated factors in old age.
OBJECTIVE
This study aims to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression and its determinants among old age.
METHOD
A comprehensive search of PubMed, Scopus, Web of sciences, Google Scholar, and Psych-info from database inception to January 2020. Moreover, the reference list of selected articles was looked at manually to have further eligible articles. The random-effects model was employed during the analysis. Stata-11 was used to determine the average prevalence of depression among old age. A sub-group analysis and sensitivity analysis were also run. A graphical inspection of the funnel plots and Egger's publication bias plot test were checked for the occurrence of publication bias.
RESULT
A search of the electronic and manual system resulted in 1263 articles. Nevertheless, after the huge screening, 42 relevant studies were identified, including, for this meta-analysis, n = 57,486 elderly populations. The average expected prevalence of depression among old age was 31.74% (95% CI 27.90, 35.59). In the sub-group analysis, the pooled prevalence was higher among developing countries; 40.78% than developed countries; 17.05%), studies utilized Geriatrics Depression Scale-30(GDS-30); 40.60% than studies that used GMS; 18.85%, study instrument, and studies having a lower sample size (40.12%) than studies with the higher sample; 20.19%.
CONCLUSION
A high prevalence rate of depression among the old population in the world was unraveled. This study can be considered as an early warning and advised health professionals, health policymakers, and other pertinent stakeholders to take effective control measures and periodic care for the elderly population.
PubMed: 34922595
DOI: 10.1186/s12991-021-00375-x