Intranasal oxytocin, social cognition and neurodevelopmental disorders: A meta-analysis.

Deficits in social cognition are pervasive and characteristic of neurodevelopmental disorders (NDDs). Clinical trials of intranasal oxytocin (IN-OT) to improve social cognition have yielded inconclusive results. The current study is a meta-analysis of randomized controlled trials (RCTs) considering the effect of IN-OT on social cognitive domains across a range of NDDs. Medline, PsychINFO and Scopus were searched for RCTs published through to July 25, 2017. Seventeen studies met inclusion criteria, comprising 466 participants with a NDD. Meta-analysis using a random-effects model, revealed that IN-OT had no significant effect on emotion recognition (Hedges' g=0.08), a moderate but non-significant effect on empathy (Hedges' g=0.49), and a small, significant effect on theory of mind (ToM) (Hedges' g=0.21). Meta-regression indicated that the effect of IN-OT on social cognition was not moderated by the diagnosis or age of participants, or the dose or frequency of IN-OT administration. The results highlight a need for more well-designed RCTs, as it remains difficult to draw conclusions about the potential for IN-OT to improve social cognition in NDDs. The promise of IN-OT should be considered tentative.

Does intranasal steroid spray technique affect side effects and compliance? Results of a patient survey.

BACKGROUND: Intranasal steroid sprays are fundamental in the medical management of inflammatory rhinological conditions. Side effects are common, but these may be related to the method of application rather than the medication itself. METHODS: A survey was distributed to patients using intranasal steroid sprays at the ENT out-patient clinic at Aberdeen Royal Infirmary over three months. This evaluated the spray technique used, side effects and compliance. RESULTS: Of 103 patients, 22 patients (21.4 per cent) reported side effects, including nasal irritation and epistaxis. Of the 20 patients with epistaxis, 80 per cent used an ipsilateral hand technique (p = 0.01). Thirty patients demonstrated poor compliance because of lack of symptom improvement or side effects. Seventy-seven per cent of this group used the ipsilateral hand technique. CONCLUSION: Patients who used their ipsilateral hand to apply the intranasal steroid spray were more likely to develop epistaxis and have poor compliance than those who used other techniques. Patients who struggle with compliance because of side effects should avoid this method of intranasal steroid application.