ABSTRACT
BACKGROUND: The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review and meta-analysis, we aim to compare the positive and negative symptoms of MIP and schizophrenia to better understand the differences between them. STUDY DESIGN: In accordance with our pre-registered protocol (CRD42021286619), we conducted a search of English-language studies up to December 16th, 2022, in PubMed, EMBASE, and PsycINFO, including stable outpatients with MIP and schizophrenia. We used the Newcastle-Ottawa Scale to measure the quality of cross-sectional, case-control, and cohort studies. STUDY RESULTS: Of the 2052 articles retrieved, we included 12 studies (6 cross-sectional, 3 case-control, and 2 cohort studies) in our meta-analysis, involving 624 individuals with MIP and 524 individuals with schizophrenia. Our analysis found no significant difference in positive symptoms between the two groups (SMD, -0.01; 95%CI, -0.13 to +0.11; p = 1). However, individuals with MIP showed significantly less negative symptoms compared to those with schizophrenia (SMD, -0.35; 95CI%, -0.54 to -0.16; p = 0.01; I2 = 54 %). Our sensitivity analysis, which included only studies with a low risk of bias, did not change the results. However, our meta-analysis is limited by its cross-sectional approach, which limits the interpretation of causal associations. Furthermore, differences in population, inclusion criteria, methodology, and drug exposure impact our findings. CONCLUSIONS: Negative symptoms are less prominent in individuals with MIP. While both groups do not differ regarding positive symptoms, raises the possibility of shared and partly different underlying neurobiological mechanisms related to MIP and schizophrenia.
Subject(s)
Methamphetamine , Psychoses, Substance-Induced , Schizophrenia , Humans , Methamphetamine/adverse effects , Schizophrenia/physiopathology , Psychoses, Substance-Induced/etiology , Central Nervous System Stimulants/adverse effects , Amphetamine-Related Disorders/complicationsABSTRACT
BACKGROUND: Mindfulness-based interventions (MBIs) have emerged as secular practices, including elements of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). While MBIs have been widely adopted for physical and mental illness, only a few available programs are explicitly adapted for psychosis. However, previous reviews have reported the vital heterogeneity regarding treatment program structure. Therefore, this review aims to compare the structure of different mindfulness protocols applied to patients with schizophrenia spectrum disorder (SSD). METHODS: A systematic search was conducted up to March 2023 in PubMed, Embase and PsycInfo. Following our protocol (CRD 42023253356), we followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. RESULTS: We included 22 randomized controlled trials (RCTs) involving 1500 patients SSD. All programs varied in structure, session components, duration, and instructor experience. While MBSR-like programs focused on stress reactivity, MBCT-like programs addressed primary symptoms of psychosis and relapse prevention. Despite the heterogeneity of programs, some common mechanisms emerged, including attention training, emotion and stress regulation, decentering, self-compassion, and cognitive restructuring. CONCLUSIONS: The critical heterogeneity found limits the interpretation of results. However, most recent trials present fewer risks of bias and more homogenous programs. Findings suggested potential benefits, such as reduced negative symptoms, increased well-being, and decreased hospitalization rates. For future studies, authors should align on more congruent MBIs programs for patients with SSD. Further research is needed to identify optimal mindfulness teaching approaches for patients with psychosis and investigate specific mechanisms of action, relevant processes, and optimal doses in varying settings.
Subject(s)
Mindfulness , Schizophrenia , Humans , Mindfulness/methods , Schizophrenia/therapy , Psychotic Disorders/therapy , Randomized Controlled Trials as Topic , Cognitive Behavioral Therapy/methodsABSTRACT
Research on negative symptoms of schizophrenia has received renewed interest since the 1980s. A scientometric analysis that objectively maps scientific knowledge, with changes in recent trends, is currently lacking. We searched the Web of Science Core Collection (WOSCC) on December 17, 2021 using relevant keywords. R-bibliometrix and CiteSpace were used to perform the analysis. We retrieved 27,568 references published between 1966 and 2022. An exponential rise in scientific interest was observed, with an average annual growth rate in publications of 16.56% from 1990 to 2010. The co-cited reference network that was retrieved presented 24 different clusters with a well-structured network (Q=0.7921; S=0.9016). Two distinct major research trends were identified: research on the conceptualization and treatment of negative symptoms. The latest trends in research on negative symptoms include evidence synthesis, nonpharmacological treatments, and computational psychiatry. Scientometric analyses provide a useful summary of changes in negative symptom research across time by identifying intellectual turning point papers and emerging trends. These results will be informative for systematic reviews, meta-analyses, and generating novel hypotheses.
Subject(s)
Psychiatry , Schizophrenia , Humans , Concept Formation , Schizophrenia/diagnosis , Systematic Reviews as TopicABSTRACT
Psilocybin is increasingly studied for its antidepressant effect, but its optimal dosage for depression remains unclear. We conducted a systematic review and a dose-response meta-analysis to find the optimal dosage of psilocybin to reduce depression scores. Following our protocol (CRD 42022220190) multiple electronic databases were searched from their inception until February 2023, to identify double-blind randomized placebo-controlled (RCTs) fixed-dose trials evaluating the use of psilocybin for adult patients with primary or secondary depression. A one-stage dose-response meta-analysis with restricted cubic splines was used. Cochrane risk of bias was used to assess risk of bias. Our analysis included seven studies with a total of 489 participants. Among these, four studies focused on primary depression (N = 366), including one study with patients suffering from treatment-resistant depression. The remaining three studies examined secondary depression (N = 123). The determined 95% effective doses per day (ED95) were 8.92, 24.68, and 36.08 mg/70 kg for patients with secondary depression, primary depression, and both subgroups, respectively. We observed significant dose-response associations for all curves, each plateauing at different levels, except for the bell-shaped curve observed in the case of secondary depression. Additionally, we found significant dose-response associations for various side effects, including physical discomfort, blood pressure increase, nausea/vomiting, headache/migraine, and the risk of prolonged psychosis. In conclusion, we discovered specific ED95 values for different populations, indicating higher ED95 values for treatment-resistant depression, primary depression, and secondary depression groups. Further RCTs are necessary for each population to determine the optimal dosage, allowing for maximum efficacy while minimizing side effects.
Subject(s)
Depression , Psychotic Disorders , Adult , Humans , Depression/drug therapy , Psilocybin/adverse effects , Antidepressive Agents/therapeutic use , Psychotic Disorders/drug therapy , Randomized Controlled Trials as TopicABSTRACT
Resumen Introducción Las Unidades Geriátricas de Agudos (UGAs) son unidades especializadas en atención de Personas Mayores (PM). Específicamente en Chile, existen pocos profesionales dedicados a esta área, pese a establecer más UGAs con un equipo interdisciplinario. Desde terapia ocupacional es posible un abordaje desde una perspectiva ocupacional, no obstante, se encontró escasa evidencia que explicite la contribución de terapia ocupacional en UGAs en el contexto chileno. Objetivo Resumir la contribución de las intervenciones realizadas por terapeutas ocupacionales a personas mayores hospitalizadas en Unidades Geriátricas de Agudos, revisando literatura nacional como internacional. Metodología Revisión bibliográfica narrativa, entre octubre del 2021 y enero del 2022. Resultados Los principales resultados destacan la contribución de terapia ocupacional para el abordaje de la fragilidad en PM, en intervenciones llevadas a cabo por equipos interdisciplinarios, la promoción y respeto por la autonomía e independencia (particularmente en Actividades de la Vida Diaria Básicas e Instrumentales), la recuperación funcional y la preparación del alta, contribuyendo a la reducción de las tasas de re-hospitalización. Conclusión La participación de la terapia ocupacional en UGAs aporta herramientas y fortalece las habilidades de las PM con el fin de permitirles desenvolverse efectivamente en sus ocupaciones, de forma independiente y autónoma en diversos contextos, principalmente en actividades de la vida diaria. Además, se busca concientizar sobre la importancia de aumentar la especialización en esta área y la necesidad de aumentar la cantidad de UGAs a nivel nacional.
Resumo Introdução As Unidades Geriátricas Agudas (UGAs) são unidades especializadas no atendimento ao idoso. Especificamente no Chile, há poucos profissionais dedicados a essa área, apesar de estabelecer unidades geriátricas mais agudas com equipe interdisciplinar. A partir da terapia ocupacional é possível uma abordagem a partir de uma perspectiva ocupacional, no entanto, foram encontradas poucas evidências que expliquem a contribuição da terapia ocupacional em UGAs no contexto chileno. Objetivo Resumir a contribuição das intervenções realizadas por terapeutas ocupacionais a idosos internados em UGAs, revisando a literatura nacional e internacional. Metodologia Revisão bibliográfica narrativa, entre outubro de 2021 e janeiro de 2022. Resultados Os principais resultados destacam a contribuição da terapia ocupacional no enfrentamento da fragilidade em idosos nas intervenções realizadas por equipes interdisciplinares, na promoção e respeito à autonomia e independência (particularmente nas Atividades Básicas e Instrumentais de Vida Diária), na recuperação funcional e na preparação para a alta, contribuindo para a redução das taxas de reinternação. Conclusão A participação da terapia ocupacional na UGAs fornece ferramentas e fortalece as habilidades dos idosos para permitir que eles realizem de forma eficaz em suas ocupações, de forma independente e autônoma em vários contextos, principalmente nas atividades da vida diária. Além disso, procura sensibilizar para a importância de aumentar a especialização nesta área e para a necessidade de aumentar o número de UGAs a nível nacional.
Abstract Introduction The Acute Geriatric Units (AGU) are units specialized in caring for the elderly people. Specifically in Chile, there are few professionals dedicated to this area, despite establishing more acute geriatric units with an interdisciplinary team. From occupational therapy, an approach from an occupational perspective is possible. However, little evidence was found that explains the contribution of occupational therapy in AGU in the Chilean context. Objetive Summarize the contribution of the interventions carried out by occupational therapists to elderly people hospitalized in AGU, reviewing national and international literature. Methodology Narrative bibliographic review, between October 2021 and January 2022. Results The main results highlight the contribution of occupational therapy to address frailty in older people in interventions carried out by interdisciplinary teams, the promotion and respect for autonomy and independence (in Basic and Instrumental Activities of Daily Living), the functional recovery and preparation for discharge, contributing to the reduction of rehospitalization rates. Conclusion The participation of occupational therapy in the AGU provides tools and strengthens the skills of older people in order to allow them to function effectively in their occupations, independently and autonomously in various contexts, mainly in activities of daily living. In addition, it seeks to raise awareness of the importance of increasing specialization in this area and the need to increase the number of AGU nationwide.
ABSTRACT
Antecedentes: Las condiciones económicas y sociales de los habitantes de calle tienen repercusiones en el acceso a los servicios sanitarios y la calidad de la atención recibida. Conocer la percepción del habitante de calle ayuda a ofrecer cuidado de enfermería de forma oportuna y completa. Objetivo Describir la percepción del habitante de calle sobre los cuidados de enfermería. Metodología Revisión integrativa de literatura de alcance descriptivo y retrospectivo; se realizó búsqueda en las bases de datos NursingOvid, Academic One File, Informe Académico, PubMed y Scopus. Se construyeron 12 ecuaciones de búsqueda a partir de la combinación de los descriptores: Habitante de calle, personas sin hogar, percepciones sociales, enfermería y atención de enfermería. Resultados Se seleccionaron 30 artículos que se sometieron a lectura y análisis a profundidad obteniendo las percepciones de los habitantes de calle frente al cuidado de enfermería. Conclusiones La percepción del habitante de calle sobre los cuidados de enfermería resulta fluctuante porque existen barreras de acceso que dificultan la atención; los profesionales de salud desconocen las necesidades de esta población y las políticas públicas resultan insuficientes en cuanto a cobertura y oportunidad de los servicios de salud lo cual repercute directamente en el cuidado de enfermería.
Background: The economic and social conditions of homeless persons have repercussions on access to health services, and the quality of care received. Recognizing the perception of homeless persons helps to offer nursing care in a timely and complete way. Objective: To describe the perception of the homeless persons about nursing care. Methodology Integrative review of descriptive and retrospective literature; The NursingOvid, Academic One File, Academic Report, PubMed and Scopus databases were searched. Twelve search equations were constructed from the combination of the descriptors: homeless people, social perceptions, nursing and nursing care. Results Thirty articles were selected and subjected to in-depth reading and analysis, obtaining the perceptions of homeless persons about nursing care. Conclusions The perception of the homeless persons about nursing care fluctuates because there are access barriers; Health professionals are unaware of the needs of this population and public policies are insufficient in terms of coverage and opportunity of health services, which have a direct impact on nursing care.
Subject(s)
Perception , Ill-Housed Persons , Nursing CareABSTRACT
Se realizó un estudio exploratorio con vistas a validar un instrumento para la evaluación del nivel de alfabetización en salud sexual y reproductiva de 30 estudiantes de medicina de Santiago de Cuba, teniendo en cuenta las habilidades para una adecuada alfabetización. Se realizaron pruebas de estabilidad con test y retest y el porcentaje de las respuestas de dichos estudiantes fue constante; asimismo, se buscó la validez aparente y de contenido por grupo de expertos, así como la factibilidad a partir de la percepción de los sujetos estudiados. Se adaptó en el contexto cubano la versión original del instrumento de medición seleccionado y la nueva versión resultó válida para la investigación en una muestra más amplia de estudiantes.
An exploratory study aimed at validating an instrument for the evaluation of the literacy level of sexual and reproductive health in 30 medicine students was carried out in Santiago de Cuba province, taking into account the skills for an appropriate literacy. Tests of stability with test and retest were carried out and the percentage of these students answers was constant; also, the apparent and content validity by a group of experts was searched, as well as the feasibility starting from the perception of the studied individuals. The original version of the selected measuring instrument was adapted in the Cuban context and the new version was valid for the investigation in a wider sample of students.
Subject(s)
Humans , Male , Adult , Evaluation of Research Programs and Tools , Health Literacy , Universities , Health EducationABSTRACT
Cuba comparte con los países desarrollados excelentes indicadores de salud infantil, que en el archipiélago antillano son el resultado, entre otros factores, de una acertada estrategia pediátrica en el nivel básico de asistencia médica