Cognitive behavioral therapy for hoarding disorder: An updated meta-analysis.

BACKGROUND: Hoarding disorder (HD) is a new disorder in DSM-5. While cognitive-behavioral therapy (CBT) is seen as the gold standard approach to treatment, the literature in this field is still emerging. METHODS: The aim of the present study is to synthesize the current treatment outcome literature on CBT for HD, as well as secondary depressive symptoms, using a meta-analytic approach. Due to a lack of controlled trials only within-group effect sizes were calculated. RESULTS: Sixteen studies were included in the meta-analysis (n = 505; mean age = 56 years; mean percentage female participants = 72%). Large effect sizes were found from pre-treatment to post-treatment (g = 1.11; 95% CI: 0.92-1.29) and from pre-treatment to follow-up (g = 1.25; 95% CI: 0.94-1.56) on HD symptoms. The gender distribution of the sample moderated treatment outcome, with larger effects seen in studies that included a larger proportion of female patients. Treatment modality (individual vs group), therapist training, use of home visits, trial type (efficacy vs effectiveness), number of treatment weeks, participant age, and study quality did not moderate treatment outcome. Small effect sizes were found from pre-treatment to post-treatment (g = 0.45; 95% CI: 0.28-0.61) for depressive symptoms and baseline depression severity, treatment modality, use of home visits, and assessment tool used did not moderate outcome. LIMITATIONS: The study is limited by the small number of studies available in this field. CONCLUSIONS: This study demonstrates that CBT for HD is an effective treatment, however, controlled trials are needed, as are trials examining the long-term efficacy of CBT for HD.

Dynamic data-driven meta-analysis for prioritisation of host genes implicated in COVID-19.

The increasing body of literature describing the role of host factors in COVID-19 pathogenesis demonstrates the need to combine diverse, multi-omic data to evaluate and substantiate the most robust evidence and inform development of therapies. Here we present a dynamic ranking of host genes implicated in human betacoronavirus infection (SARS-CoV-2, SARS-CoV, MERS-CoV, seasonal coronaviruses). We conducted an extensive systematic review of experiments identifying potential host factors. Gene lists from diverse sources were integrated using Meta-Analysis by Information Content (MAIC). This previously described algorithm uses data-driven gene list weightings to produce a comprehensive ranked list of implicated host genes. From 32 datasets, the top ranked gene was PPIA, encoding cyclophilin A, a druggable target using cyclosporine. Other highly-ranked genes included proposed prognostic factors (CXCL10, CD4, CD3E) and investigational therapeutic targets (IL1A) for COVID-19. Gene rankings also inform the interpretation of COVID-19 GWAS results, implicating FYCO1 over other nearby genes in a disease-associated locus on chromosome 3. Researchers can search and review the gene rankings and the contribution of different experimental methods to gene rank at https://baillielab.net/maic/covid19 . As new data are published we will regularly update the list of genes as a resource to inform and prioritise future studies.

The role of familial and sibling factors on abdominal adiposity: a study of south Indian urban children.

BACKGROUND AND OBJECTIVES: Childhood obesity is increasing in urban India. This study aimed to examine the associations of younger siblings abdominal adiposity with individual, familial and environmental factors, in urban school aged siblings. METHODS AND STUDY DESIGN: Weight, height and waist circumference of 2906 siblings aged 3-16 years were measured along with details on demographics, diet, lifestyle, behavior and reported parental anthropometrics. Abdominal adiposity was classified as waist circumference above the age and sex specific 75th percentile value. The associations of various factors with abdominal adiposity in the younger siblings were examined through logistic regression analyses. RESULTS: Sibling, familial factors and environmental factors had significant associations with abdominal adiposity. The odds of a younger sibling having abdominal adiposity was greatest (OR=3.16, 95% confidence interval (95% CI): 2.27 to 4.42), when the older sibling had abdominal adiposity, followed by the odds ratio of both parents being overweight (OR=1.63, 95% CI: 1.33 to 1.99) compared to neither being overweight. The influence of abdominal adiposity of the older sibling was greater when the siblings were of the same sex (OR=3.55, 95% CI: 2.24 to 5.65) than when they were of different sex (OR=2.73, 95% CI: 1.67 to 4.46); the odds ratio being highest when both siblings were males. CONCLUSIONS: The younger sibling's abdominal adiposity is associated with that of his/her sibling and parental obesity, in addition to other known risk factors in urban south Indian families. Interventions to prevent childhood obesity need to also consider the sibling effect along with the other known factors.