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Journal of Psychiatric Research May 2024Expert consensus operationalized treatment response and remission in obsessive-compulsive disorder (OCD) as a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) reduction... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Expert consensus operationalized treatment response and remission in obsessive-compulsive disorder (OCD) as a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) reduction ≥35% and score ≤12 with ≤2 on Clinical Global Impressions Improvement (CGI-I) and Severity (CGI-S) scales, respectively. However, there has been scant empirical evidence supporting these definitions.
METHODS
We conducted a systematic review and an individual participant data meta-analysis of randomized-controlled trials (RCTs) in adults with OCD to determine optimal Y-BOCS thresholds for response and remission. We estimated pooled sensitivity/specificity for each percent reduction threshold (response) or posttreatment score (remission) to determine response and remission defined by a CGI-I and CGI-S ≤ 2, respectively.
RESULTS
Individual participant data from 25 of 94 eligible RCTs (1235 participants) were included. The optimal threshold for response was ≥30% Y-BOCS reduction and for remission was ≤15 posttreatment Y-BOCS. However, differences in sensitivity and specificity between the optimal and nearby thresholds for response and remission were small with some uncertainty demonstrated by the confidence ellipses.
CONCLUSION
While the empirically derived Y-BOCS thresholds in our meta-analysis differ from expert consensus, given the predominance of data from more recent trials of OCD, which involved more refractory participants and novel treatment modalities as opposed to first-line therapies, we recommend the continued use of the consensus definitions.
Topics: Adult; Humans; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Treatment Outcome
PubMed: 38598877
DOI: 10.1016/j.jpsychires.2024.03.044 -
Frontiers in Human Neuroscience 2024Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated... (Review)
Review
BACKGROUND
Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders.
OBJECTIVES
Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders.
METHODS
systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales.
RESULTS
Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies.
CONCLUSION
MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.
PubMed: 38571523
DOI: 10.3389/fnhum.2024.1245707 -
Health & Place May 2024The decline of children's opportunities to play outdoors raises a new concern about the quality of outdoor play environments, and their developmental and well-being... (Review)
Review
The decline of children's opportunities to play outdoors raises a new concern about the quality of outdoor play environments, and their developmental and well-being benefits for children. This systematic review aims to synthesize the associations between outdoor play features and children's behavior and health. PRISMA guidelines were followed (2021). The inclusion criteria were studies with children aged between 5 and 12 (Population); that addressed presence, absence or disposition of equipment, natural elements, loose parts, resources availability, type of terrain and space modifications (Intervention or Exposure); in pre-post intervention or between groups (Comparison); related to health and behavior in different domains (Outcomes); with an experimental, observational, descriptive or longitudinal design (Study design). Indoor context, adult-led activities and structured activities were excluded. A literature search of five databases (PubMed, Web of Science, ERIC, Scopus, and PsycINFO) was concluded in March 2022. After identifying 28,772 records, duplicates and irrelevant titles were removed, and abstracts and full-text articles were screened in duplicate. The remaining 51 eligible articles (45 primary studies) were assessed for risk of bias with QualSyst. A narrative synthesis of the results was conducted. The most frequent behavioral or health outcome addressed was physical activity. Included studies focused on the following space features: fixed structures, space naturalness, floor markings, loose parts/equipment, area available, and the combination of factors. Although some positive effects were found, the heterogeneity between studies did not allow to draw firm conclusions on the effects of each environmental feature on primary children's health and behavior. Systematic review registration: PROSPERO CRD42020179501.
Topics: Humans; Child; Play and Playthings; Exercise; Child Behavior; Environment Design; Child, Preschool; Health Behavior
PubMed: 38569450
DOI: 10.1016/j.healthplace.2024.103235 -
Journal of Magnetic Resonance Imaging :... Mar 2024Patients often mention distress, anxiety, or claustrophobia related to MRI, resulting in no-shows, disturbances of the workflow, and lasting psychological effects....
BACKGROUND
Patients often mention distress, anxiety, or claustrophobia related to MRI, resulting in no-shows, disturbances of the workflow, and lasting psychological effects. Patients' experience varies and is moderated by socio-demographic aspects alongside the clinical condition. While qualitative studies help understand individuals' experiences, to date a systematic review and aggregation of MRI individuals' experience is lacking.
PURPOSE
To investigate how adult patients experience MRI, and the characterizing factors.
STUDY TYPE
Systematic review with meta-aggregation and meta-synthesis.
POPULATION
220 patients' reported experience of adults undergoing clinical MRI and 144 quotes from eight qualitative studies.
ASSESSMENT
Systematic search in PubMed, Scopus, Web of Science, and PsycInfo databases according to the PRISMA guidelines. For quality appraisal, the Joanna Briggs Institute (JBI) tools were used. Convergent segregated approach was undertaken.
DATA ANALYSIS
Participant recruitment, setting of exploration, type of interview, and analysis extracted through Joana Briggs Qualitative Assessment and Review Instrument (JBI QARI) tool. Meta-synthesis was supported by a concept map. For meta-aggregation, direct patient quotes were extracted, findings grouped, themes and characterizing factors at each stage abstracted, and categories coded in two cycles. Frequency of statements was quantified. Interviews' raw data unavailability impeded computer-aided analysis.
RESULTS
Eight articles out of 12,755 initial studies, 220 patients, were included. Meta-aggregation of 144 patient quotes answered: (1) experiences before, at the scanning table, during, and after an MRI, (2) differences based on clinical condition, and (3) characterizing factors, including coping strategies, look-and-feel of medical technology, interaction with professionals, and information. Seven publications lack participants' health literacy level, occupation, and eight studies lack developmental conditions, ethnicity, or country of origin. Six studies were conducted in university hospitals.
DATA CONCLUSION
Aggregation of patients' quotes provide a foundational description of adult patients' MRI experience across the stages of an MRI process. Insufficient raw data of individual quotes and limited socio-demographic diversity may constrain the understanding of individual experience and characterizing factors.
LEVEL OF EVIDENCE
1 TECHNICAL EFFICACY: Stage 5.
PubMed: 38544326
DOI: 10.1002/jmri.29365 -
Brain Sciences Feb 2024Cannabis use disorder (CUD) is a growing public health concern, with rising prevalence and significant impact on individuals across age groups. This systematic review... (Review)
Review
Cannabis use disorder (CUD) is a growing public health concern, with rising prevalence and significant impact on individuals across age groups. This systematic review examines 24 studies investigating pharmacological and non-pharmacological interventions for CUD among adolescents (up to 17), young adults (18-24), and older adults (25-65). Database searches were conducted for randomized controlled trials of CUD interventions reporting outcomes such as cannabis use, abstinence, withdrawal symptoms, and treatment retention. For adolescents, interventions such as contingent rewards and family engagement have shown promise, while young adults benefit from technology-based platforms and peer support. In older adults, pharmacological adjuncts combined with counseling have shown promise in enhancing treatment outcomes. However, optimal treatment combinations remain uncertain, highlighting the need for further research. Addressing CUD requires tailored interventions that acknowledge developmental stages and challenges across the lifespan. Although promising interventions exist, further comparative effectiveness research is needed to delineate the most efficacious approaches.
PubMed: 38539616
DOI: 10.3390/brainsci14030227 -
Development and Psychopathology Mar 2024Friendships are a potential factor that influence maltreated children's risk for psychopathology. This systematic review examined (1) how friendships influence the...
Friendships are a potential factor that influence maltreated children's risk for psychopathology. This systematic review examined (1) how friendships influence the association between child maltreatment and psychopathology and (2) developmental differences in how friendships influence this association. Four databases were searched. Inclusion criteria were primary study, quantitative, measures of maltreatment and friendship up to the age of 18 years, measures of psychopathology up to the age of 24 years, and a non-maltreated sample. Exclusion criteria were qualitative, reviews or meta-analyses, no distinction between maltreatment and other trauma, and no differentiation between friendships and other support. Risk of bias was assessed. Data were narratively synthesized. Two hundred thirty-five articles were retrieved for full review. Fourteen met inclusion criteria ( = 98,676 participants). Eleven of the fourteen studies found that some aspect of friendships influenced the association between maltreatment and psychopathology, with positive qualities generally decreasing risk and negative qualities increasing risk for psychopathology. However, peer support exacerbated maltreated children's risk for psychopathology in two studies. Only three studies assessed friendship prior to adolescence, which precluded conclusions regarding developmental differences. Future research should consider developmental differences and use findings and validated measures from the peer relations literature to better understand how friendships influence maltreated youth's vulnerability to psychopathology.
PubMed: 38532717
DOI: 10.1017/S0954579424000476 -
Frontiers in Psychiatry 2024Complex trauma is associated with complex-posttraumatic stress disorder (CPTSD). While dissociative processes, developmental factors and systemic factors are implicated...
UNLABELLED
Complex trauma is associated with complex-posttraumatic stress disorder (CPTSD). While dissociative processes, developmental factors and systemic factors are implicated in the development of CPTSD, there are no existing systematic reviews examining the underlying pathways linking complex trauma and CPTSD. This study aims to systematically review evidence of mediating factors linking complex trauma exposure in childhood (birth to eighteen years of age) and subsequent development of CPTSD (via self-reports and diagnostic assessments). All clinical, at-risk and community-sampled articles on three online databases (PsycINFO, MedLine and Embase) were systematically searched, along with grey literature from ProQuest. Fifteen articles were eligible for inclusion according to pre-determined eligibility criteria and a search strategy. Five categories of mediating processes were identified: 1) dissociative processes; 2) relationship with self; 3) emotional developmental processes; 4) social developmental processes; and 5) systemic and contextual factors. Further research is required to examine the extent to which targeting these mediators may act as mechanisms for change in supporting individuals to heal from complex trauma.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022346152.
PubMed: 38510809
DOI: 10.3389/fpsyt.2024.1331256 -
Neuroscience and Biobehavioral Reviews May 2024Major depressive, bipolar, or psychotic disorders are preceded by earlier manifestations in behaviours and experiences. We present a synthesis of evidence on... (Meta-Analysis)
Meta-Analysis Review
Major depressive, bipolar, or psychotic disorders are preceded by earlier manifestations in behaviours and experiences. We present a synthesis of evidence on associations between person-level antecedents (behaviour, performance, psychopathology) in childhood, adolescence, or early adulthood and later onsets of major depressive disorder, bipolar disorder, or psychotic disorder based on prospective studies published up to September 16, 2022. We screened 11,342 records, identified 460 eligible publications, and extracted 570 risk ratios quantifying the relationships between 52 antecedents and onsets in 198 unique samples with prospective follow-up of 122,766 individuals from a mean age of 12.4 to a mean age of 24.8 for 1522,426 person years of follow-up. We completed meta-analyses of 12 antecedents with adequate data. Psychotic symptoms, depressive symptoms, anxiety, disruptive behaviors, affective lability, and sleep problems were transdiagnostic antecedents associated with onsets of depressive, bipolar, and psychotic disorders. Attention-deficit/hyperactivity and hypomanic symptoms specifically predicted bipolar disorder. While transdiagnostic and diagnosis-specific antecedents inform targeted prevention and help understand pathogenic mechanisms, extensive gaps in evidence indicate potential for improving early risk identification.
Topics: Adolescent; Humans; Adult; Child; Young Adult; Bipolar Disorder; Depressive Disorder, Major; Prospective Studies; Psychotic Disorders; Anxiety Disorders
PubMed: 38494121
DOI: 10.1016/j.neubiorev.2024.105625 -
BMC Public Health Mar 2024Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in... (Meta-Analysis)
Meta-Analysis
Systematic review and meta-analysis of physical activity interventions to increase elementary children's motor competence: a comprehensive school physical activity program perspective.
BACKGROUND
Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in children's PA participation is their motor competence (MC). The comprehensive school physical activity program (CSPAP) framework offers a way to classify existing PA interventions that have included children's MC development and understand the potential avenues for supporting children's MC. However, there have been no systematic reviews or meta-analyses of PA interventions and their effects on the MC of elementary school children (aged 5-12 years) from a CSPAP perspective.
METHODS
This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched seven electronic databases (PubMed/Medline, Embase, ERIC, SPORTDiscus, CINAHL, Web of Science, and PsycINFO) for articles on 29 November 2021. The CSPAP framework was used to categorize the different intervention approaches. This review was registered with PROSPERO (CRD42020179866).
RESULTS
Twenty-seven studies were included in the review, and twenty-six studies were included in the meta-analysis. A wide range of PA intervention approaches (e.g., single component or multicomponent) within the context of the CSPAP framework appear to be promising pathways in enhancing children's MC. The results of the aggregate meta-analysis presented that effect sizes for the development of MC from pre-and post- intervention ranged from moderate to large (Hedges' g = 0.41-0.79). The analysis revealed that the predicted moderators, including study length, delivery agent, and study design, did not result in statistically significant moderate variations in MC outcomes. There was, however, considerable heterogeneity in study design, instruments, and study context, and studies were implemented in over 11 countries across diverse settings.
CONCLUSIONS
This study uniquely contributes to the literature through its primary focus on the effectiveness of PA interventions on elementary children's MC. This review emphasizes the importance of customizing CSPAP to fit the specific characteristics of each school setting, including its environmental, demographic, and resource attributes. The effectiveness of CSPAP, particularly its physical education (PE) component, is significantly enhanced when these programs are adapted to address the unique needs of each school. This adaptation can be effectively achieved through targeted professional teacher training, ensuring that PE programs are not only contextually relevant but also optimized for maximum impact in diverse educational environments. Researchers and practitioners should pursue how to effectively translate the evidence into practice to better conceptualize CSPAPs designed for children's MC development.
Topics: Child; Humans; Exercise; Body Weight; Schools
PubMed: 38491432
DOI: 10.1186/s12889-024-18145-1 -
Nature Human Behaviour May 2024Developmental language disorder (DLD) is a common neurodevelopmental disorder with adverse impacts that continue into adulthood. However, its neural bases remain... (Meta-Analysis)
Meta-Analysis
Developmental language disorder (DLD) is a common neurodevelopmental disorder with adverse impacts that continue into adulthood. However, its neural bases remain unclear. Here we address this gap by systematically identifying and quantitatively synthesizing neuroanatomical studies of DLD using co-localization likelihood estimation, a recently developed neuroanatomical meta-analytic technique. Analyses of structural brain data (22 peer-reviewed papers, 577 participants) revealed highly consistent anomalies only in the basal ganglia (100% of participant groups in which this structure was examined, weighted by group sample sizes; 99.8% permutation-based likelihood the anomaly clustering was not due to chance). These anomalies were localized specifically to the anterior neostriatum (again 100% weighted proportion and 99.8% likelihood). As expected given the task dependence of activation, functional neuroimaging data (11 peer-reviewed papers, 414 participants) yielded less consistency, though anomalies again occurred primarily in the basal ganglia (79.0% and 95.1%). Multiple sensitivity analyses indicated that the patterns were robust. The meta-analyses elucidate the neuroanatomical signature of DLD, and implicate the basal ganglia in particular. The findings support the procedural circuit deficit hypothesis of DLD, have basic research and translational implications for the disorder, and advance our understanding of the neuroanatomy of language.
Topics: Humans; Language Development Disorders; Basal Ganglia; Brain; Functional Neuroimaging; Neuroanatomy; Neostriatum
PubMed: 38491094
DOI: 10.1038/s41562-024-01843-6