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Eating and Weight Disorders : EWD Aug 2023Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity.
METHODS
In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake.
RESULTS
Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy.
DISCUSSION
The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies.
LEVEL OF EVIDENCE
Level I-Evidence obtained from: systematic reviews and meta-analyses.
Topics: Female; Humans; Pregnancy; Body Dissatisfaction; Body Image; Feeding and Eating Disorders; Gestational Age; Peripartum Period
PubMed: 37526698
DOI: 10.1007/s40519-023-01595-8 -
Progress in Neuro-psychopharmacology &... Dec 2023Alterations of functional network connectivity have been implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). Recent studies also suggest... (Review)
Review
Alterations of functional network connectivity have been implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). Recent studies also suggest that the temporal dynamics of functional connectivity (dFC) can be altered in these disorders. Here, we summarized the existing literature on dFC in SCZ and BD, and their association with psychopathological and cognitive features. We systematically searched PubMed, Web of Science, and Scopus for studies investigating dFC in SCZ and BD and identified 77 studies. Our findings support a general model of dysconnectivity of dFC in SCZ, whereas a heterogeneous picture arose in BD. Although dFC alterations are more severe and widespread in SCZ compared to BD, dysfunctions of a triple network system underlying goal-directed behavior and sensory-motor networks were present in both disorders. Furthermore, in SCZ, positive and negative symptoms were associated with abnormal dFC. Implications for understanding the pathophysiology of disorders, the role of neurotransmitters, and treatments on dFC are discussed. The lack of standards for dFC metrics, replication studies, and the use of small samples represent major limitations for the field.
Topics: Humans; Schizophrenia; Bipolar Disorder; Magnetic Resonance Imaging
PubMed: 37473954
DOI: 10.1016/j.pnpbp.2023.110827 -
Journal of Affective Disorders Nov 2023Whereas the risk and course of psychopathology in offspring of parents with bipolar disorder (BD) have been the primary focus of high-risk offspring studies to date,... (Review)
Review
OBJECTIVE
Whereas the risk and course of psychopathology in offspring of parents with bipolar disorder (BD) have been the primary focus of high-risk offspring studies to date, functional outcomes have not been given much attention. We present a systematic review of functional outcomes and quality of life (QoL) across development in offspring of parents with BD and aim to explore the role of offspring psychopathology in these outcomes.
METHOD
We searched Embase, MEDLINE, PsycINFO, Web of Science, Cochrane Central, and Google Scholar from inception to June 24, 2022, for studies referring to functional outcomes (global, social, academic or occupational) or QoL in offspring of parents with BD.
RESULTS
From the 6470 records identified, 39 studies were retained (global = 17; social = 17; school = 16; occupational = 3; QoL = 5), including 13 studies that examined multiple domains. For all domains, high heterogeneity was found in study methods and quality. Only 56 % of studies adjusted for offspring psychopathology, impeding interpretation. Global and social functioning generally seemed to be impaired among older offspring (>16 years). Academic performance appeared to be unaffected. School behavior, occupational functioning, and QoL showed mixed results. Offspring psychopathology is associated with social functioning, but the relationship of offspring psychopathology with other domains is less clear.
CONCLUSION
Studies on functional outcome in offspring of parents with BD show predominantly mixed results. Inconsistent adjustment of psychopathology and age limits conclusive interpretation. Functional outcomes should be prioritized as research topics in high-risk studies and the potential associations between familial risk status, offspring psychopathology, and age may inform prevention strategies.
Topics: Humans; Bipolar Disorder; Quality of Life; Child of Impaired Parents; Parents; Psychopathology
PubMed: 37467795
DOI: 10.1016/j.jad.2023.07.072 -
Frontiers in Psychiatry 2023Terrorism and violent extremism are major social threats worldwide and are committed not only by men but also by women. Previous research has shown indications of...
INTRODUCTION
Terrorism and violent extremism are major social threats worldwide and are committed not only by men but also by women. Previous research has shown indications of psychopathology, among other personal and contextual factors, as a potential risk factor for perpetrating terrorist and violent extremist crimes. Despite the fact that women have engaged in acts of terrorism and violent extremism throughout history, the vast majority of literature on psychopathology so far has been mainly focused on men with terrorist and violent extremist behavior. As women's engagement in terrorism and violent extremism is increasing, and gender differences in psychopathology in offenders of terrorism or violent extremism may exist based on empirical evidence for such differences in offenders of violence, gender-informed research into psychopathology as a potential risk factor for offending is of pivotal importance for improving the effectiveness of counter-terrorism interventions. The present systematic review was designed to examine what empirical knowledge exists on the presence and potential contributing role of psychopathology in female perpetrators of terrorism or violent extremism.
METHODS
A literature search was conducted to identify primary source studies in PsycINFO, PubMed, Embase, Web of Science, and Sociological Abstracts. ASReview as an artificial intelligence software was used to screen references.
RESULTS
In total, eight studies were included, of which only two studies distinguished prevalence rates and types of psychopathology separately for women, indicating personality disorder as most common. All four out of the eight studies that reported on the relationship between psychopathology and terrorism and violent extremism assumed psychopathology to be a contributing factor in engaging in terrorist or violent extremist acts. However, none of these four studies reported on potentially present female-specific mechanisms of the role of psychopathology in offenses.
DISCUSSION
The present systematic review draws the striking conclusion that there is a lack of clearly described empirical studies on psychopathology in female perpetrators of terrorism and violent extremism and emphasizes the importance of more future empirically based inquiries on this topic by the forensic psychiatric field.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275354, identifier: CRD42021275354.
PubMed: 37441140
DOI: 10.3389/fpsyt.2023.1123243 -
Current Opinion in Psychiatry Nov 2023This scoping review aimed to provide a recent update on how to address dysfunctional physical activity and exercise (DEx), and on effects and experiences from including...
PURPOSE OF REVIEW
This scoping review aimed to provide a recent update on how to address dysfunctional physical activity and exercise (DEx), and on effects and experiences from including supervised and adapted physical activity or exercise (PAE), during treatment of eating disorders.
RECENT FINDINGS
A systematic search for peer-reviewed publications in the period 2021-2023 generated 10 original studies and 6 reviews, including one meta-analysis (reporting according to PRISMA and SWiM). Findings showed that DEx was effectively managed by use of psychoeducation and/or PAE. Inclusion of PAE as part of treatment showed low-to-moderate impact on health and positive or neutral effects on eating disorder psychopathology. There were no reports of adverse events. For individuals with anorexia nervosa, PAE improved physical fitness with no influence on body weight or body composition unless progressive resistance training was conducted. For individuals with bulimia nervosa, DEx was reduced simultaneously with increased functional exercise and successful implementation of physical activity recommendations during treatment. Experiences by individuals with eating disorders and clinicians, including accredited exercise physiologists, pointed to positive benefits by including PAE in treatment.
SUMMARY
Lack of consensus about DEx and of recommendations for PAE in official treatment guidelines hinder adequate approaches to these issues in eating disorder treatment.
Topics: Humans; Anorexia Nervosa; Body Weight; Bulimia Nervosa; Exercise; Feeding and Eating Disorders
PubMed: 37435847
DOI: 10.1097/YCO.0000000000000892 -
JCPP Advances Dec 2022Infants of parents with perinatal anxiety are at elevated likelihood of experiencing disruption in the parent-infant relationship, as well as difficulties with...
BACKGROUND
Infants of parents with perinatal anxiety are at elevated likelihood of experiencing disruption in the parent-infant relationship, as well as difficulties with socio-emotional functioning in later development. Interventions delivered in the perinatal period have the potential to protect the early dyadic relationship and support infants' ongoing development and socio-emotional outcomes. This review primarily aimed to examine the efficacy of perinatal interventions on parent anxiety, infant socio-emotional development/temperament, and parent-infant relationship outcomes. Secondarily, the review sought to understand how interventions focused principally on one member of the dyad affected the outcomes of the other, and which intervention components were common to successful interventions.
METHOD
Five electronic databases as well as manual search procedures were used to identify randomised controlled trials according to a PICO eligibility criteria framework. Risk of bias assessments were undertaken, and a narrative synthesis was conducted. The review was pre-registered on PROSPERO (CRD42021254799).
RESULTS
Twelve studies were analysed in total, including five interventions focused on the adult, and seven interventions focused on the infant, or the infant's relationship with their parent. Interventions incorporating cognitive behavioural strategies for affective disorders showed reductions in parent anxiety ( = 3), and interventions focusing on altering distorted maternal internal representations showed positive change in parent-child dyadic interactions, and infant outcomes ( = 2). Evidence that interventions focused on one partner of the dyad led to improved outcomes for the other partner was limited. However, evidence was of mixed methodological quality.
CONCLUSIONS
It is important to integrate both parents and infants into treatment programmes for perinatal anxiety. Implications for clinical practice and future intervention trials are discussed.
PubMed: 37431423
DOI: 10.1002/jcv2.12116 -
Frontiers in Psychiatry 2023Many individuals diagnosed with schizophrenia and related disorders experience insufficient symptom relief from currently available treatment options. Researching...
BACKGROUND
Many individuals diagnosed with schizophrenia and related disorders experience insufficient symptom relief from currently available treatment options. Researching additional venues should be prioritized. This systematic review, designed in accordance with PRISMA, examined the effect of targeted and structured dog-assisted interventions as a supplementary treatment.
METHODS
Randomized as well as non-randomized studies were included. Systematic searches were conducted in APA PsycInfo, AMED, CENTRAL, Cinahl, Embase, Medline, Web of Science, and in several sources covering "gray" (unpublished) literature. In addition, forward and backward citation searches were performed. A narrative synthesis was conducted. Quality of evidence and risk of bias were assessed in accordance with GRADE and RoB2/ROBINS-I criteria.
RESULTS
12 publications from 11 different studies met eligibility criteria. Overall, studies showed diverging results. General psychopathology, positive and negative symptoms of psychosis, anxiety, stress, self-esteem, self-determination, lower body strength, social function, and quality of life were among the outcome measures with significant improvement. Most documentation for significant improvement was found for positive symptoms. One study indicated significant deterioration of non-personal social behavior. The risk of bias was high or serious for most of the outcome measures. Three outcome measures were associated with some concerns regarding risk of bias, and three with low risk of bias. Quality of evidence was graded low or very low for all outcome measures.
CONCLUSIONS
The included studies indicate potential effects of dog-assisted interventions for adults diagnosed with schizophrenia and related disorders, mostly beneficial. Nevertheless, low number of participants, heterogeneity, and risk of bias complicate the interpretation of results. Carefully designed randomized controlled trials are needed to determine causality between interventions and treatment effects.
PubMed: 37426092
DOI: 10.3389/fpsyt.2023.1192075 -
Frontiers in Psychology 2023Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood... (Review)
Review
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
PubMed: 37425159
DOI: 10.3389/fpsyg.2023.1156415 -
Behaviour Research and Therapy Aug 2023Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early... (Meta-Analysis)
Meta-Analysis
Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.
Topics: Humans; Memory; Stress Disorders, Post-Traumatic; Sleep; Sleep Deprivation; Cognition
PubMed: 37422952
DOI: 10.1016/j.brat.2023.104359 -
JMIR Mental Health Jul 2023A large body of research has documented the efficacy of psychological interventions integrated with virtual reality (VR) therapies in treating psychiatric disorders.... (Review)
Review
BACKGROUND
A large body of research has documented the efficacy of psychological interventions integrated with virtual reality (VR) therapies in treating psychiatric disorders. However, the concept of positive mental health calls for a 2-fold approach in which both symptoms and positive functioning should be addressed by modern interventions.
OBJECTIVE
This review aimed to summarize studies that applied VR therapies by embracing the positive mental health perspective.
METHODS
A literature search was conducted by entering the following keywords-"virtual reality" AND "intervention" OR "treatment" OR "therapy" AND "mental health" NOT "systematic review or meta-analysis"-and limiting it to "journal article" and the English language. To be included in this review, articles had to present at least one quantitative measure of positive functioning and one quantitative measure of symptoms or distress and had to investigate adult populations, including populations with psychiatric disorders.
RESULTS
A total of 20 articles were included. They described various VR protocols that were applied for the treatment of anxiety disorders (5/20, 25%), depression (2/20, 10%), posttraumatic stress disorder (3/20, 15%), psychosis (3/20, 15%), and stress (7/20, 35%). Most of the studies (13/20, 65%) showed the beneficial effects of VR therapies in improving stress and negative symptoms. However, 35% (7/20) of the studies showed no or a small effect on the various dimensions of positivity, particularly in clinical samples.
CONCLUSIONS
VR interventions might be cost-effective and largely scalable, but further research is needed to develop existing VR software and treatments according to the modern positive mental health approach.
PubMed: 37410520
DOI: 10.2196/44998