The efficacy of social skills training (SST) and social cognition and interaction training (SCIT) for negative symptoms: A meta-analysis

Background and objectives The efficacy of antipsychotic drugs in improving negative symptoms of schizophrenia remains controversial. Psychological interventions, such as Social Skills Training (SST) and Social Cognition and Interaction Training (SCIT), have been developed and applied in clinical practice. The current meta-analysis was therefore conducted to evaluate the efficacy of controlled clinical trials using SST and SCIT on treating negative symptoms. Methods Systematical searches were carried out on PubMed, Web of Science, and PsycINFO databases. The standardized mean difference (SMD) with 95% confidence intervals (CI) was calculated to assess the effect size of SST/SCIT on negative symptoms. Subgroup and meta-regression analyses were conducted to explore sources of heterogeneity and identify potential factors that may influence their efficacy. Results A total of 23 studies including 1441 individuals with schizophrenia were included. The SST group included 8 studies with 635 individuals, and the SCIT group included 15 studies with 806 individuals. The effect size for the efficacy of SST on negative symptoms was -0.44 (95% CI: -0.60 to -0.28; p < 0.01), while SCIT was -0.16 (95% CI: -0.30 to -0.02; p < 0.01). Conclusions Our findings suggest that while both SST and SCIT can alleviate negative symptoms, the former appears to be more effective. Our results provide evidence-based guidance for the application of these interventions in both hospitalized and community individuals and can help inform the treatment and intervention of individuals with schizophrenia. (AU)

Efficacy of Noninvasive Brain Stimulation in Treating General Psychopathology Symptoms in Schizophrenia: A Meta-Analysis.

OBJECTIVES: Noninvasive brain stimulation (NIBS) has been shown to effectively alleviate negative and positive symptoms in patients with schizophrenia. However, its impact on depressive symptoms and general psychopathology symptoms (GPSs), which are crucial for functional outcomes, remains uncertain. We aimed to compare the efficacy of various NIBS interventions in treating depressive symptoms and GPSs. METHODS: We conducted a comprehensive search of multiple databases and performed a meta-analysis to evaluate the efficacy of NIBS in treating depressive symptoms and GPSs in schizophrenia. The effect sizes of NIBS for depression symptoms and GPSs were estimated using standard mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses were employed to examine potential influencing factors on the pooled SMD of NIBS for GPSs. RESULTS: Our search yielded 35 randomized controlled trials involving 1715 individuals diagnosed with schizophrenia. The protocol of this systematic review was registered with INPLASY (protocol ID: INPLASY202320082). Neither repetitive transcranial magnetic stimulation (rTMS) nor transcranial direct current stimulation (tDCS) demonstrated significant improvements in depressive symptoms compared to sham controls. NIBS exhibited a small-to-moderate effect size for GPSs, with a pooled SMD of -0.2956 (95% CI: -0.459 to -0.132) and a heterogeneity (I2) of 58.9% (95% CI: 41.5% to 71.1%; p < 0.01) based on a random-effects model. Subgroup analyses of different types of NIBS, different frequencies of rTMS, and different stimulation sites of rTMS revealed no significant differences. Only sex had a significant influence on the effect size of NIBS for general psychopathology symptoms (p < 0.05). However, rTMS might be superior to tDCS, and high-frequency rTMS outperformed low-frequency rTMS in treating GPSs. CONCLUSIONS: We found a small-to-moderate effect size of NIBS in alleviating GPSs in patients with schizophrenia. Both rTMS and tDCS were more effective than sham stimulation in reducing GPSs in schizophrenia. The frequency used was associated with rTMS efficacy for GPSs.

The mediating role of negative symptoms in "secondary factors" determining social functioning in chronic schizophrenia.

Background: Chronic schizophrenia is significantly influenced by negative symptoms, with several known contributors to secondary negative symptoms. However, the impact of these factors and negative symptoms on social functioning warrants further exploration. Methods: We assessed the clinical symptoms, antipsychotic adverse reactions, and social functioning of 283 hospitalized patients with chronic schizophrenia using various standardized interviews and scales. We conducted multiple regression and mediation analyses to elucidate the impact of secondary factors on negative symptoms, and the relationship among these "secondary factors," negative symptoms, and social functioning. Results: Our findings identified depressive symptoms, extrapyramidal symptoms, and positive symptoms as significant contributors to secondary negative symptoms. We found that negative symptoms play a notable mediating role in the effect of depressive and positive symptoms on social functioning. However, the relationship between positive symptoms, negative symptoms, and social functioning proved to be intricate. Conclusion: Our findings propose that negative symptoms act as pivotal mediators in the correlation between "secondary factors" (including the depressive symptoms and positive symptoms) and social functioning. The treatment of chronic schizophrenia necessitates focusing on key factors such as depressive and positive symptoms, which might significantly contribute to the development of secondary negative symptoms. Further research is essential to clarify the complex relationship among positive symptoms, negative symptoms, and social functioning in schizophrenia.

The efficacy of homestyle rehabilitation on negative symptoms in chronic schizophrenia: A randomized controlled trial.

Objective: Schizophrenia is a debilitating mental disorder with a high disability rate that is characterized by negative symptoms such as apathy, hyperactivity, and anhedonia that can make daily life challenging and impair social functioning. In this study, we aim to investigate the effectiveness of homestyle rehabilitation in mitigating these negative symptoms and associated factors. Methods: A randomized controlled trial was conducted to compare the efficacy of hospital rehabilitation and homestyle rehabilitation for negative symptoms in 100 individuals diagnosed with schizophrenia. The participants were divided randomly into two groups, each persisting for 3 months. The primary outcome measures were the Scale for Assessment of Negative Symptoms (SANS) and Global Assessment of Functioning (GAF). The secondary outcome measures included the Positive Symptom Assessment Scale (SAPS), Calgary Schizophrenia Depression Scale (CDSS), Simpson-Angus Scale (SAS), and Abnormal Involuntary Movement Scale (AIMS). The trial aimed to compare the effectiveness of the two rehabilitation methods. Results: Homestyle rehabilitation for negative symptoms was found to be more effective than hospital rehabilitation, according to the changes in SANS (T = 2.07, p = 0.04). Further analysis using multiple regression indicated that improvements in depressive symptoms (T = 6.88, p < 0.001) and involuntary motor symptoms (T = 2.75, p = 0.007) were associated with a reduction in negative symptoms. Conclusion: Homestyle rehabilitation may have greater potential than hospital rehabilitation in improving negative symptoms, making it an effective rehabilitation model. Further research is necessary to investigate factors such as depressive symptoms and involuntary motor symptoms, which may be associated with the improvement of negative symptoms. Additionally, more attention should be given to addressing secondary negative symptoms in rehabilitation interventions.

The pooled prevalence of the mental problems of Chinese medical staff during the COVID-19 outbreak: A meta-analysis.

BACKGROUND: The COVID-19 pandemic has had a great impact on the mental health of the medical staff in China, especially those on the first-line (frontline) of the pandemic. But the profile of the mental problem of nationwide Chinese medical staff is still unclear, especially about the sleep problems. METHODS: There are five databases (PubMed, Embase, CNKI, Wanfang Database and Web of Science) searched to identify the published studies on the mental health of the medical staff in China during the COVID-19 outbreak. The pooled prevalence of mental problems of Chinese medical staff during the pandemic were calculated, especially for the first-line medical staff. Subgroup analysis and meta-regression analysis were performed to identify the potential impact factors. RESULTS: A total of 71 articles including 98,533 participants are included in this meta-analysis. The results showed that the pooled prevalence of the mental problems was as follows: anxiety problem 27%, depression problem 29%, sleep problem 40%. Subgroup analysis showed that there were significant differences in the prevalence of anxiety and depression problems between first-line and non-first-line medical staff (p < 0.01). Sex had a significant impact on the sleep of first-line medical staff (p < 0.01). LIMITATIONS: There may be heterogeneity among the included studies. The analysis of potential influencing factors remains limited. CONCLUSIONS: The prevalence of adverse mental problems among medical staff is high during the COVID-19 outbreak. We need to pay special attention to the mental health of first-line medical staff, especially the sleep problems of female first-line workers.

The Prevalence of Mental Problems for Chinese Children and Adolescents During COVID-19 in China: A Systematic Review and Meta-Analysis.

The outbreak of coronavirus disease 2019 (COVID-19) has caused mental problems among the public and medical staff in China, especially for children and adolescents, a vulnerable group that might present with more mental problems. It seems that there is a rapid growth in the mental problems (such as depression or anxiety) of Chinese children and adolescents during the outbreak of COVID-19. Although several studies reported the prevalence of depression or anxiety problems for children and adolescents, the results are different across different age groups and sex groups. Moreover, the sample size of these studies was small. In the present study, we aim to perform a meta-analysis to identify the confirmed prevalence of depression and anxiety problems for Chinese children and adolescents during home confinement. Five databases were searched including PubMed, Web of Science, PsycINFO, Google Scholar, and the China National Knowledge Infrastructure (CNKI), and both inclusion and exclusion criteria were developed. Finally, a total of 12 studies were included in this meta-analysis. The protocol of this systematic review was registered with INPLASY (protocol ID: INPLASY202150032). It found that the pooled prevalence of mental problems was 28% (95% confidence interval, CI: 0.22-0.34), and the depression and anxiety problem for children and adolescents in China was 22% (95% CI: 0.16-0.30) and 25% (95% CI: 0.20-0.32) based on a random effect model, separately. Subgroup analysis was used to identify that there are no differences between different age groups (primary and middle school vs. high school) (p = 0.26). Meta-regression analysis was performed and the results showed that the moderator of boy percentage was a significant factor (p = 0.04). It indicated that there was an increasing number of children and adolescents with mental problems during the home confinement. It suggested that we should pay more attention to this vulnerable population during a public health crisis in the future, especially for the girls groups, and more detailed implements for mental health management were needed and should be prepared. Systematic Review: The protocol of this systematic review was registered with INPLASY. The protocol ID was INPLASY202150032.

Problems in treatment and training of autistic children growing up in China: A follow-up case report.

INTRODUCTION: Currently, interventions for children with autism spectrum disorders (ASD) in China are mainly carried out by professionals in rehabilitation institutions and special schools. However, when autistic children are older, they do not receive effective training and treatment, and there is no specific place in society to accommodate autistic adults. Mental hospitals are usually their ultimate home. CASE PRESENTATION: We report a 22-year-old male with ASD. The manifestation and/or intervention from the age of 3 years to now were recorded. He has been hospitalized in the closed ward of a mental hospital since 2015. CONCLUSION: This report typically present the current problems in treatment and training of autistic children growing up in China. Life-long rehabilitation training is important for every patient with ASD. Relevant policies and resources in China should be optimized in terms of medical treatment and health care, education and training, social assistance, social security, labor employment, and social culture.