A Systematic Review and Narrative Synthesis of Cognitive Training in the Treatment of Mental Illness and Substance Use Disorder.

Introduction: The one unifying and distinguishing feature of all neuropsychiatric illnesses is the co-occurrence of cognitive dysfunction. Cognitive training (CT) was developed to enhance neural connectivity and cognition and improve day-to-day functioning. However, the benefits of CT are still debated. This current systematic review aimed to examine the efficacy of CT and to identify diagnostic and CT characteristics associated with superior outcomes across a range of psychiatric disorders. Method: Studies investigating CT in psychiatric illnesses were extracted from Embase, PubMed, CINAHL, PsycINFO, and PsycARTICLES up to 17 August 2023. Inclusion criteria were randomised control trials (RCT) and English language. The primary search strategy included terms relating to cognitive training, cognitive remediation, cognitive enhancement, or cognitive rehabilitation and randomised control trials, clinical trials, or experiments. Risk of bias was assessed using RevMan Web version 8.1.1. Narrative synthesis was used to analyse findings. Due to the heterogeneity of participant demographics, diagnoses, and interventions, meta-analyses were considered inappropriate. Results: Fifteen studies, including a total of 1075 participants, were identified. Approximately 67% of studies reported significant improvements in at least one trained domain of cognitive function after CT, and 47% observed improvements in psychiatric symptoms or function. Cognitive transfer effects were not observed. Sample sizes for studies were generally small, and most CT durations were 6 weeks or less. Conclusions: Findings suggest that CT can improve cognitive function in trained domains, though little evidence of cognitive transfer effects was observed. Due to the lack of standardisation in CT format and delivery, and inadequate measures of psychiatric symptoms or daily function, there is insufficient evidence to conclude whether or not this technique may benefit cognitive impairment in psychiatric disorders, or lead to subsequent improvement in disease symptomatology. Further studies of longer duration and using consistent methodologies must be conducted to identify the benefits of CT in psychiatric disorders.

Characteristics and outcomes of community-based perinatal peer support: Protocol for a systematic review.

BACKGROUND: Mental health issues and parenting difficulties in the perinatal period are common, and have significant negative impacts on individuals, families, and broader society. Community-based peer support programs might be an effective adjunct to standard mental health interventions in perinatal mental health issues, specifically where low-cost interventions are required, or access to professional care is limited. METHODS: A systematic review will be undertaken. Searches will be conducted on four electronic databases (Pubmed, Embase, Cinahl, and PsycINFO), using terms related to perinatal mental health and peer support. Literature will be screened by title and abstract and then by full text. Selected studies will be evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Data relevant to community-based perinatal peer support intervention characteristics and outcomes will be extracted, and synthesised narratively. DISCUSSION: This review will contribute to the existing evidence about perinatal mental health peer support, by synthesising information about community-based interventions specifically. The findings will be used to inform the design, implementation, and evaluation of a community-based perinatal mental health peer support program in urban and rural/remote hospital and health services in Australia. TRIAL REGISTRATION: Systematic review registration: CRD42023451568.

The Impact of Free Sugar on Human Health-A Narrative Review.

The importance of nutrition in human health has been understood for over a century. However, debate is ongoing regarding the role of added and free sugars in physiological and neurological health. In this narrative review, we have addressed several key issues around this debate and the major health conditions previously associated with sugar. We aim to determine the current evidence regarding the role of free sugars in human health, specifically obesity, diabetes, cardiovascular diseases, cognition, and mood. We also present some predominant theories on mechanisms of action. The findings suggest a negative effect of excessive added sugar consumption on human health and wellbeing. Specific class and source of carbohydrate appears to greatly influence the impact of these macronutrients on health. Further research into individual effects of carbohydrate forms in diverse populations is needed to understand the complex relationship between sugar and health.

The Impact of Free and Added Sugars on Cognitive Function: A Systematic Review and Meta-Analysis.

A relationship between excessive sugar consumption and cognitive function has been described in animal models, but the specific effects of sugars in humans remains unclear. This systematic review and meta-analysis aimed to evaluate the current knowledge, research characteristics, and quality of evidence of studies investigating the impacts of free and added sugars on human cognition in healthy participants. The review identified 77 studies (65 experimental trials, n = 3831; 9 cross-sectional studies, n = 11,456; and 3 cohort studies, n = 2059). All cohort studies and eight of the nine cross-sectional studies found significant positive correlations between added sugar consumption and risk of cognitive impairment. Four studies identified reduced risk of cognitive impairment associated with natural fructose-containing foods. The majority of randomised control trials assessed short-term glucose facilitation effects on cognitive outcomes. The results from these studies suggest the need for a tightly regulated blood glucose level, dependent on individualised physiological factors, for optimal cognitive function. A meta-analysis of a subset of studies that assessed the impact of glucose on recall found improvements in immediate free recall compared to controls (p = 0.002). The findings highlight the potentially detrimental effect of excessive, long-term, or prenatal added sugar consumption on cognitive function. Further research is needed to examine the specific effects of free and added sugars on cognitive function.