-
The British Journal of Psychiatry : the... Jul 2017Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.To determine the... (Meta-Analysis)
Meta-Analysis Review
Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes.To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD.We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies.Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall.Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area.
Topics: Alcoholism; Humans; Patient Compliance; Personality Disorders; Treatment Outcome
PubMed: 28385703
DOI: 10.1192/bjp.bp.116.194720 -
Journal of Psychosomatic Research Dec 2016Depression is common in people with long term conditions, and is associated with worse medical outcomes. Previous research shows perseverative negative thinking (e.g.... (Review)
Review
OBJECTIVE
Depression is common in people with long term conditions, and is associated with worse medical outcomes. Previous research shows perseverative negative thinking (e.g. worry, rumination) predicts subsequent depression and worse medical outcomes, suggesting interventions targeting perseverative negative thinking could improve depression and medical outcomes. Previous studies recruited healthy individuals, however. This review aimed to determine the temporal relationship and strength of prospective association of perseverative negative thinking with depression, anxiety and emotional distress in people with long term conditions.
METHOD
Four electronic databases were searched for studies including standardised measures of perseverative negative thinking and depression, anxiety or emotional distress, and which presented prospective associations. Findings were narratively synthesized.
RESULTS
Thirty studies were identified in a range of long term conditions. Perseverative negative thinking and subsequent depression, anxiety or emotional distress were significantly correlated in the majority of studies (bivariate r=0.23 to r=0.73). 25 studies controlled for confounders, and in 15 perseverative negative thinking predicted subsequent depression, anxiety or emotional distress. Results varied according to condition and study quality. Six of 7 studies found bivariate associations between depression, anxiety or emotional distress and subsequent perseverative negative thinking, though 2 studies controlling for key covariates found no association. Few studies assessed the impact of perseverative negative thinking on medical outcomes.
CONCLUSION
Strongest evidence supported perseverative negative thinking predicting subsequent depression, anxiety and emotional distress in people with long term conditions. Further prospective research is warranted to clarify the association of perseverative negative thinking with subsequent poor medical outcomes.
Topics: Adult; Anxiety; Chronic Disease; Depression; Female; Humans; Male; Pessimism; Stereotyped Behavior; Stress, Psychological; Young Adult
PubMed: 27894469
DOI: 10.1016/j.jpsychores.2016.11.004 -
Digital Health 2016Africa is labelled the world's fastest-growing 'mobile region'. Considering such growth and the fragility of the continent's healthcare, mHealth has flourished. This... (Review)
Review
Exploring the ambivalent evidence base of mobile health (mHealth): A systematic literature review on the use of mobile phones for the improvement of community health in Africa.
BACKGROUND
Africa is labelled the world's fastest-growing 'mobile region'. Considering such growth and the fragility of the continent's healthcare, mHealth has flourished. This review explores mHealth for community health in Africa in order to assess its still ambivalent evidence base.
METHODS
Using PubMed, Web of Science, OvidSP and Google Scholar, a systematic review was conducted of one decade (2005-2015) of peer-reviewed literature on mHealth in Africa. Data analysis focused on qualifications of success and failure. Impact evaluations of project assessments ( = 65) were complemented with general analyses/overviews of mHealth's effectiveness ( = 35).
RESULTS
Review of these texts reveals ambivalence in the appraisal of mHealth; essentially, the critical stance in general analyses/overviews is absent from project assessments. Especially weak evidence concerning sustainability and scalability is stressed in overviews. Project assessments are more optimistic. Their analysis suggests a causal connection between simplicity and success. Effective interventions are thus characterized by straightforward design and modest objectives. Greatest impediments of impact are general technology-related issues and intervention inappropriateness due to insufficient understanding of beneficiaries and specific context of use (circumstantial complications).
CONCLUSION
Distinguishing between these two categories of complications helps to break the deadlock that marks the mHealth debate and add nuance to claims that mHealth's evidence base is weak. Constructive realism - rather than unfounded optimism or pessimism without nuance - should guide the design of interventions. Besides anticipative of technology-related complications, such realism must lead to either basic interventions or to smart mHealth shaped by deep understanding of the context of implementation.
PubMed: 29942576
DOI: 10.1177/2055207616679264 -
Tumori 2015Research on the topic of hope began a long time ago but, more recently, interest in this construct has focused mainly on the development of psychometric tools for its... (Review)
Review
AIMS AND BACKGROUND
Research on the topic of hope began a long time ago but, more recently, interest in this construct has focused mainly on the development of psychometric tools for its assessment. The 2 steps of the present article are defining the construct of hope by completing a preliminary review of the literature and analyzing the tools used to assess hope in the setting of oncologic medicine, conducting a systematic review of the existing scientific literature.
METHODS AND STUDY DESIGN
Our study was conducted in 2 stages. The first stage involved a nonsystematic preliminary review of the literature, the second a systematic search in all the medical journals contained in the Medline database as of 2012. The literature identified at the first stage was divided according to several topical categories, i.e., theoretical, empirical, and clinical works on the construct of hope. In the second systematic search, we identified the main psychometric tools used to measure hope in the field of clinical oncology and assessed their validity.
RESULTS
A total of 22 articles were identified. What emerged when we pooled the findings of our 2 lines of research was that, despite its broad theoretical definitions, the construct of hope can be broken down to a few constituent elements when hope is studied using currently available psychometric tools. In particular, these identified constituent elements were coping, spiritual well-being, quality of life, distress, and depression.
CONCLUSIONS
The factors contained in the construct of hope include temporality, future, expectancy, motivation, and interconnectedness. The review of the scientific literature does not reveal a clear definition of hope. Multidisciplinary studies are needed to communicate different perspectives (medical, psychological, spiritual, theological) among each other for better definition of the constituent elements of hope in order to support the hope with specific interventions.
Topics: Adaptation, Psychological; Concept Formation; Hope; Humans; Interdisciplinary Communication; Medical Oncology; Neoplasms; Optimism; Pessimism; Prognosis; Psychometrics; Qualitative Research; Quality of Life; Reproducibility of Results; Research Design; Self Concept; Self Report; Severity of Illness Index; Spirituality; Stress, Psychological; Truth Disclosure; Uncertainty
PubMed: 25953443
DOI: 10.5301/tj.5000349