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1.
Psychiatr Q ; 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32445003

RESUMO

DSM-5 introduced a number of modifications to the catatonic syndrome, which is now closer to Kahlbaum's original concept. The aim of the present study was to assess residents' and qualified psychiatrists' knowledge, experience and views about the treatment of catatonia in acute psychiatric care in Budapest, Hungary. Authors approached all psychiatric units that provide acute psychiatric care (N = 11) in Budapest and invited all psychiatrists and residents, who consented, to participate in the survey, completing a 13 items questionnaire. Ninety-eight fully qualified and trainee psychiatrists completed the questionnaire. Although 84.7% of the participants rated their knowledge of catatonia as moderate or significant, there were a number of obvious mistakes in their answers. Most catatonic signs and symptoms were not identified by almost 50% of the respondents and the frequency of catatonia was also underestimated. The views of the majority of the participants reflected the Kraepelinian concept, in which catatonia is primarily associated with schizophrenia. Although benzodiazepines are widely recommended as a first line treatment for catatonia, only 69.4% of participants chose them as a treatment option. In view of its clinical importance, catatonia deserves more attention in the education and training of medical students and psychiatric residents.

2.
Psychiatr Q ; 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32350748

RESUMO

Effective and prompt medication treatment is essential for schizophrenia patients to alleviate psychotic symptoms and improve prognosis. The treatment rate of schizophrenia usually varies greatly across studies. This is a meta-analysis that examined the overall treatment rate of schizophrenia in China. Both international (PubMed, EMBASE, PsycINFO, Web of Science) and Chinese (CNKI, WanFang and Sinomed) databases were searched. The random effects model was used to analyze the data. Fifteen studies with 1,219,472 patients were included. This meta-analysis found that 73% (95%CI: 66%, 80%) of schizophrenia patients received treatment in any type of medical institutions, while 31.0% (95%CI = 21.0%, 41.0%) received treatment in psychiatric institutions. Studies conducted in middle region of China (76.8% for any type of medical institutions; 42.6% for psychiatric institutions) and those published before 2007 (74.6% for any type of medical institutions; 31.3% for psychiatric institutions) reported significantly higher treatment rates. Studies using combined diagnostic instruments had a higher treatment rate of schizophrenia (72.0%) in any type of medical institutions, while using the Chinese classification of Mental Disorders (47.7%) and including both rural and urban areas (35.7%) had higher treatment rates of schizophrenia in psychiatric institutions. The treatment rate of schizophrenia was relatively high in China, but most treatments were delivered in non-psychiatric medical institutions. Greater efforts should be made to improve the provision of accessible mental health services for schizophrenia patients in this part of the world.

3.
Transl Psychiatry ; 10(1): 117, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32327628

RESUMO

Antipsychotic-induced dyslipidemia could increase the risk of cardiovascular diseases. This is a meta-analysis of randomized double-blind placebo-controlled trials to examine the efficacy and safety of adjunctive metformin for dyslipidemia induced by antipsychotics in schizophrenia. The standardized mean differences (SMDs) and risk ratios (RRs) with their 95% confidence intervals (CIs) were calculated using the random-effects model with the RevMan 5.3 version software. The primary outcome was the change of serum lipid level. Twelve studies with 1215 schizophrenia patients (592 in metformin group and 623 in placebo group) were included and analyzed. Adjunctive metformin was significantly superior to placebo with regards to low density lipoprotein cholesterol (LDL-C) [SMD: -0.37 (95%CI:-0.69, -0.05), P = 0.02; I2 = 78%], total cholesterol [SMD: -0.47 (95%CI:-0.66, -0.29), P < 0.00001; I2 = 49%], triglyceride [SMD: -0.33 (95%CI:-0.45, -0.20), P < 0.00001; I2 = 0%], and high density lipoprotein cholesterol [SMD: 0.29 (95%CI:0.02, 0.57), P = 0.03; I2 = 69%]. The superiority of metformin in improving LDL-C level disappeared in a sensitivity analysis and 80% (8/10) of subgroup analyses. Metformin was significantly superior to placebo with regards to decrease in body weight, body mass index, glycated hemoglobin A1c, fasting insulin, and homeostasis model assessment-insulin resistance (P = 0.002-0.01), but not regarding changes in waist circumference, waist-to-hip rate, leptin, fasting glucose, and blood pressure (P = 0.07-0.33). The rates of discontinuation due to any reason [RR: 0.97 (95%CI: 0.66, 1.43), P = 0.89; I2 = 0%] was similar between the two groups. Adjunctive metformin could be useful to improve total cholesterol and triglyceride levels, but it was not effective in improving LDL-C level in schizophrenia.

4.
Asian J Psychiatr ; 49: 101968, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32135482

RESUMO

BACKGROUND: Electroconvulsive therapy (ECT) is effective in treating adolescents with severe psychiatric disorders. This study examined the knowledge, experiences and attitudes of adolescents with severe psychiatric disorders and their caregivers towards ECT in China. METHODS: A total of 158 participants, including 79 adolescents who received ECT and their caregivers (n = 79), were enrolled in this study. Their knowledge and experiences about and attitudes towards ECT were evaluated with self-administered data collection forms. RESULTS: Only around half of patients and caregivers reported that they received sufficient information about the process, the therapeutic and side effects, and the risks of ECT, although most believed that ECT is beneficial, and around half believed that ECT is safe. Around one third of patients and caregivers reported that only critically ill patients should receive ECT. More than half of patients experienced side effects, such as memory impairment, headache and short-term confusion. CONCLUSIONS: Sufficient information about ECT should be provided to adolescents with severe psychiatric disorders and their caregivers prior to treatment, with particular focus on the treatment process and possible side effects.

5.
Asian J Psychiatr ; 49: 101828, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115395

RESUMO

This was a meta-analysis of randomized controlled trials (RCTs) comparing the effects of cognitive behavioural therapy for insomnia (CBTI) as a monotherapy and active control treatments in persons with insomnia who have no major medical conditions or psychiatric comorbidities. PubMed, PsycINFO, EMBASE, Cochrane Library databases, WanFang and CNKI were systematically and independently searched. Standardized mean differences (SMDs) and risk ratio (RR) with their 95% confidence intervals (CIs) were calculated. Nine RCTs with 12 treatment arms comparing CBTI (n = 479) and active control (n = 510) groups were analyzed. Compared to the active control group, the CBTI group showed significantly less improvement in insomnia at post-CBTI assessment in terms of sleep efficiency (SMD: 0.32, 95% CI: 0.00 to 0.63), sleep latency (SMD: -0.33, 95% CI: -0.56 to -0.09), wake after sleep onset (SMD: -0.27, 95% CI: -0.52 to -0.01), the total scores of Pittsburgh Sleep Quality Index (SMD: -0.52, 95% CI: -0.86 to -0.19), the Insomnia Symptom Index (SMD: -0.68, 95% CI: -1.01 to -0.36), the Dysfunctional Attitudes and Beliefs About Sleep Scale (SMD: -0.76, 95% CI: -1.25 to -0.27), and the Athens Insomnia Scale (SMD: -0.66, 95% CI: -1.07 to -0.24). In this meta-analysis, CBTI monotherapy showed no advantage in improving insomnia compared with other standard treatments.

6.
J Affect Disord ; 268: 20-27, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32158003

RESUMO

BACKGROUNDS: Depression in children and adolescents is usually under-recognized. The findings of epidemiological studies on depressive symptoms in primary school students are inconsistent across studies. This study reports a systematic review and meta-analysis on the prevalence of depressive symptoms in primary school students in China. METHODS: Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data. RESULTS: Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms. CONCLUSIONS: Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.

8.
Sleep Breath ; 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32072469

RESUMO

PURPOSE: Poor sleep quality is common in medical students and is associated with a number of negative health outcomes. However, the prevalence estimates of poor sleep quality in medical students vary widely across studies. We thus conducted a meta-analysis of the prevalence of poor sleep quality and its mediating factors in medical students. METHODS: A systematic literature search of PubMed, EMBASE, Web of Science, PsycINFO, and Medline Complete was performed. The random-effects model was used to analyze the pooled prevalence of poor sleep quality and its 95% confidence intervals (CIs). RESULTS: A total of 57 studies with 25,735 medical students were included. The pooled prevalence of poor sleep quality was 52.7% (95% CI: 45.3% to 60.1%) using the Pittsburgh Sleep Quality Index (PSQI). The pooled mean total PSQI score across 41 studies with available data was 6.1 (95% CI: 5.6 to 6.5). Subgroup analyses found that PSQI cutoff value and study region were associated with the prevalence of poor sleep quality (P = 0.0003 VS. P = 0.005). Across the continents, poor sleep quality was most common in Europe, followed by the Americas, Africa, Asia, and Oceania. Meta-regression analyses found that smaller sample size (slope = - 0.0001, P = 0.009) was significantly associated with higher prevalence of poor sleep quality. CONCLUSIONS: Poor sleep quality is common among medical students, especially in Europe and the Americas continets. Due to the negative health outcomes, regular screening of poor sleep quality and effective interventions are needed for medical students.

10.
J Affect Disord ; 267: 123-130, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32063563

RESUMO

OBJECTIVES: This is a meta-analysis of randomized controlled trials (RCTs) to examine the efficacy and safety of adjunctive folate for three major mental disorders (schizophrenia, bipolar disorder, and major depressive disorder (MDD)). METHODS: Review Manager Program Version 5.3 was used to analyze data. RESULTS: Fourteen studies with 16 RCTs (n = 1,520) on folate for schizophrenia (4 RCTs, n = 210), mood disorders (i.e., unipolar and bipolar depression) (1 RCT, n = 60), bipolar disorder (2 RCTs, n = 189) and MDD (9 RCTs, n = 1,061) were analyzed separately by diagnosis. For schizophrenia, adjunctive folate was not superior to placebo in terms of total psychopathology (standardized mean difference (SMD) = -0.14, 95% confidential interval (CI): -0.67, 0.39; I2 = 30%, P = 0.60), and positive (SMD = 0.09, 95% CI: -0.44, 0.62; I2 = not applicable, P = 0.74), negative (SMD = -0.39, 95% CI:-0.84, 0.05; I2 = 50%, P = 0.08), and general symptom scores (SMD = -0.33, 95%CI:-0.87, 0.20; I2 = not applicable, P = 0.22). For bipolar and unipolar depression, adjunctive folate was significantly superior to placebo in improving depressive symptoms. For bipolar disorder, adjunctive folate was effective in treating the acute phase of mania in bipolar disorder, but not in the acute phase of depression. For MDD, adjunctive folate was significantly superior to placebo in improving depressive symptoms (SMD = -0.38, 95%CI: -0.66, -0.09; I2 = 71%, P = 0.01), which was confirmed in 5 of the 10 subgroups. Discontinuation due to any reason and adverse drug reactions were similar between folate and placebo in each diagnostic category. CONCLUSION: This systematic review found adjunctive folate appeared to be effective and safe for MDD and bipolar manic episode, but it was not effective in treating schizophrenia.

11.
J Affect Disord ; 267: 78-85, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32063576

RESUMO

BACKGROUND: Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children. METHODS: PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0. RESULTS: Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410-2.429) but not overweight (OR = 1.068, 95% CI: 0.889-1.283) children and adolescents were more likely to have MDD. CONCLUSION: Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.

12.
Ideggyogy Sz ; 73(1-2): 43-49, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32057203

RESUMO

Background and purpose: With improving treatment options, more attention is being paid to the neurocognitive symptoms related to hepatitis C infection (HCI). While HCI-related neurocognitive impairments are frequently subclinical, they can influence patients' quality of life and fitness to work. Objective - The aim of this study was to assess HCI patients' neurocognitive functions and explore the correlations between disease variables and neurocognitive symptoms. Methods: The study was conducted between January 1, 2013 and December 31, 2015. All patients with HCI were included in the study who were registered at the Hepatology Outpatient Clinic of Szent István and Szent László Hospitals, met inclusion criteria and volunteered to participate. Patients' sociodemographic data and medical history were recorded in a questionnaire designed for the study. The 21-item Beck Depression Inventory was used to detect depressive symptoms. Six computerized tests were used to evaluate patients' neuropsychological functions. Results: Sixty patients participated in the study. In comparison with general population standards, patients demonstrated poorer performance in several neurocognitive tests. Neuropsychological performance was correlated with age, sex, length of time since HCI diagnosis, Fibroscan score and the number of previous antiviral treatments. Conclusion: The study's main finding is that compared to general population standards, patients with hepatitis C virus-related disease exhibit impaired neuropsychological functioning in visuomotor and visuospatial functions, working memory, executive functions, and reaction time. Executive functions and reaction time were the most sensitive indicators for the length and severity of the disease. Deterioration in these functions has a major negative effect on work performance particularly in certain occupations.


Assuntos
Transtornos Cognitivos , Depressão , Hepatite C , Qualidade de Vida , Transtornos Cognitivos/complicações , Depressão/complicações , Hepatite C/complicações , Humanos , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica
13.
Asian J Psychiatr ; 48: 101902, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31896433

RESUMO

AIMS: Voluntary admission rates of schizophrenia vary widely across studies. In order to make the topic be informed by evidence, it is important to have accurate estimates. This meta-analysis examined the worldwide prevalence of voluntary admissions for patients with schizophrenia. METHOD: PubMed, EMBASE, PsycINFO, the Cochrane Library, Web of Science and Medline databases were systematically searched, from their commencement date until 19th November 2018. Meta-analysis of included studies was performed using the random-effects model. RESULTS: Thirty-five studies with 134,100 schizophrenia patients were included. The overall voluntary admission rate of schizophrenia was 61.9 % (95 %CI: 52.3 %-70.7 %), while the involuntary rate was 43.0 % (95 %CI: 34.8 %-51.7 %). Subgroup analyses revealed that patients in Europe had significantly higher voluntary admission rates, while their North American counterparts were more likely admitted involuntarily. Papers published prior to 2008 reported higher involuntary admission rates. Meta-regression analyses showed that higher male percentage and higher study quality were significantly associated with higher voluntary admission rate. CONCLUSION: Although the worldwide prevalence of voluntary admissions was higher than that of involuntary admissions, the latter was common for schizophrenia. With the continuing liberalization of mental health laws broadening community-based psychiatric services, the rate of voluntary psychiatric admissions is expected to further increase over time.

14.
J Adv Nurs ; 76(4): 980-990, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31960498

RESUMO

AIMS: Sexual harassment towards nurses is a major concern universally, but no meta-analysis on the worldwide prevalence of sexual harassment towards nurses has yet been published. This study examined the worldwide prevalence of sexual harassment against nurses and explored its moderating factors. DESIGN: Meta-analysis of observational studies. DATA SOURCES: The PubMed, PsycINFO, EMBASE, and Web of Science databases from their commencement date to February 2018 were systematically and independently searched by two investigators. REVIEW METHODS: Data on the prevalence of sexual harassment experienced by nurses were extracted and pooled using the random-effects model. RESULTS: A total of 43 studies covering 52,345 nurses were included in the analyses. Female nurses accounted for 83.87% of the 32,970 subjects in 25 studies with available data on gender ratio. The prevalence of sexual harassment towards nurses in the past 12 months and during nursing career were 12.6% (95% CI: 10.9-14.4%) and 53.4% (95% CI: 23.1-83.7%), respectively. Gender, use of the WHO questionnaires, lower middle-income and high-income countries, sample size, survey year, and mean age of subjects were significantly associated with the prevalence of sexual harassment. CONCLUSION: The high prevalence of sexual harassment against nurses found in this meta-analysis represents the ongoing sexism and deleterious effects (e.g., poor work quality and efficiency, increased stress and job dissatisfaction) in the profession. Appropriate preventive measures, training, and empowerment of nurses are needed to ensure workplace safety and equality in this profession. IMPACT: The study addressed the worldwide prevalence of sexual harassment against nurses and its moderating factors. Health authorities and hospital administrators should develop organizational policy and preventive strategies to ensure nurses' workplace safety and equality.

15.
Psychiatr Q ; 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31965454

RESUMO

Neuroinflammation appears to be associated with the neurobiology of depression, and treatments targeting inflammation have shown promising results in depression. This meta-analysis examined the efficacy and safety of minocycline, an anti-inflammatory drug, for the treatment of depressive symptoms. A systematic electronic literature search was independently conducted by two investigators. Standardized mean differences (SMDs) and risk ratio (RR) with their 95% confidence interval (CI) were calculated using a random-effect model. Four RCTs (n = 211) were identified for meta-analysis. Minocycline showed a significant trend of improvement in depressive symptoms compared to placebo [4 RCTs, n = 190, SMD: -0.54 (95%CI:-1.12, 0.04), P = 0.07; I2 = 73%]. Subgroup analyses showed that minocycline was superior to placebo in improving depressive symptoms in studies of unipolar depression (3 RCTs, n = 151, SMD: -0.77 (95%CI:-1.32, -0.22), P = 0.006; I2 = 60%) and in studies using minocycline monotherapy [SMD: -1.06 (95%CI:-1.68, -0.44), P = 0.0008]. The rates of discontinuation due to any reasons [RR: 1.48 (95%CI: 0.79, 2.77), P = 0.22, I2 = 0%] and adverse drug reactions [RR: 0.32 to 1.98 (95%CI: 0.03, 14.74), P = 0.19 to 0.84, I2 = 0% to 31%] were similar between minocycline and placebo. Minocycline appears to be effective and well-tolerated in ameliorating depressive symptoms in unipolar depression. Future large RCTs with sufficient duration is needed to confirm the positive effects of minocycline in treating depressive symptoms.

16.
J Affect Disord ; 265: 63-70, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31957693

RESUMO

OBJECTIVES: This is a meta-analysis of randomized double-blind controlled-placebo trials (RCTs) examining the effectiveness, tolerability, and safety of intranasal esketamine in treating major depressive disorder (MDD). METHODS: Standardized mean difference (SMD), risk ratio (RR) and their 95% confidence intervals (CIs) were calculated using RevMan version 5.3. RESULTS: Four RCTs with 7 active arms covering 708 patients with MDD on intranasal esketamine (n = 419) and placebo (n = 289) were included. Compared with placebo, adjunctive intranasal esketamine was associated with significantly greater study-defined response (RR=1.39, 95%CI: 1.18 to 1.64, P<0.0001) and remission (RR=1.42, 95%CI: 1.17 to 1.72, P = 0.0004) at endpoint assessment. Intranasal esketamine had greater study-defined response starting at 2 h (RR= 2.77, 95%CI: 1.62 to 4.76, P = 0.0002), peaking at 24 h (RR=5.42, 95%CI: 1.38 to 21.20, P = 0.02), and at least lasting for 28 days (RR=1.36, 95%CI: 1.16 to 1.58, P = 0.0001). Similarly, intranasal esketamine had significantly greater study-defined remission starting at 2 h (RR=7.71, 95%CI: 2.16 to 27.55, P = 0.002), peaking at 24 h (RR=6.87, 95%CI: 1.55 to 30.35, P = 0.01), and lasting for 28 days (RR=1.38, 95%CI: 1.11 to 1.72, P = 0.004). Intranasal esketamine had a significantly higher rate of discontinuation due to intolerability (RR=3.50, 95%CI: 1.38 to 8.86, P = 0.008). Discontinuation due to any reasons and inefficacy were similar between the two groups. CONCLUSION: Intranasal esketamine appears to have an ultra-rapid antidepressant effect for MDD, at least lasting for 28 days. The long-term therapeutic effect and safety of intranasal esketamine need to be further examined in large-scale RCTs.

17.
Psychiatr Serv ; 71(1): 83-86, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31575350

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to examine the prevalence of voluntary and involuntary psychiatric admissions for severe mental illness in China and explore their associated factors. METHODS: The PubMed, Cochrane Library, PsycINFO, EMBASE, CNKI, CQVIP, and WanFang databases were systematically searched for the span since their inception to October 2018. Meta-analyses were conducted with the random-effects model. RESULTS: Fourteen studies with 94,305 patients were included in the analyses. The voluntary and involuntary admission rates were 30.3% (95% confidence interval [CI]=18.06% to 46.23%) and 32.3% (95% CI=10.39% to 66.21%), respectively, for severe mental illness and 19.6% (95% CI=14.09% to 26.54%) and 44.3% (95% CI=5.98% to 90.88%), respectively, for schizophrenia. Meta-regression analyses found an increase in the voluntary admission rate between 1998 and 2018. CONCLUSIONS: The voluntary admission rate for severe mental illness has increased in China, whereas the involuntary admission rate has remained high, particularly for schizophrenia. Concerted efforts should be made to further decrease the rate of involuntary admissions.

18.
Top Stroke Rehabil ; 27(1): 75-80, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31566117

RESUMO

Objective: This meta-analysis systematically analyzed and compared oral health between stroke patients and controls.Data source: The electronic databases of PubMed, EMBASE, PsycINFO, Medline and Web of Science were independently searched by two authors from their inception to 14 June 2018.Study selection: Eleven studies comparing oral health between stroke patients (n = 1,742) and controls (n = 1,193) were analyzed.Data extraction: The full texts of the 11 studies were independently reviewed. Data on oral health were independently extracted by two authors.Data synthesis: Mean differences (MD) and 95% confidence intervals (CI) were calculated and synthesized using fixed or random-effects models, as appropriate. Compared to controls, stroke patients had poorer oral health: they had more Dental Caries (5 studies; MD = 2.89, 95% CI: 0.91-4.88, p= .04), but less Remaining Teeth scores (6 studies; MD = -2.93, 95% CI: -3.91, -1.95; p < .00001). Both the Plaque Index (3 studies; MD = 0.21, 95% CI: 0.14, 0.28; p < .00001) and Gingival Index scores (4 studies; MD = 0.22, 95% CI: 0.14, 0.30; p < .00001) were significantly higher in stroke patients, indicating worse periodontal status.Conclusions: Stroke patients had poorer overall oral health status compared to controls. Given the importance of oral health to overall health, further research on screening for oral health problems after stroke should be conducted and effective management strategies should be devised and implemented.

19.
Perspect Psychiatr Care ; 56(1): 102-111, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31066059

RESUMO

PURPOSE: Bipolar disorder (BD) is frequently misdiagnosed, which can lead to negative outcomes. The 32-item Hypomania Checklist (HCL-32) is one of the most widely used self-reported screening instruments for hypomanic symptoms, which has several short versions. This systematic review examined the psychometric properties of HCL-32 short versions. DESIGN AND METHODS: Five international databases were systematically and independently searched by two researchers for studies that developed the HCL short versions. Basic demographic and clinical characteristics and the psychometric properties of the HCL short versions were recorded. FINDINGS: Eighteen studies were identified. The majority of the HCL short versions showed satisfactory to good psychometric properties. PRACTICE IMPLICATIONS: Validated HCL short versions with satisfactory psychometric properties may be helpful in screening for BD.

20.
Pharmacopsychiatry ; 53(1): 5-13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31207653

RESUMO

BACKGROUND: Results of previous studies on the safety and efficacy of adjunctive reboxetine for schizophrenia have been inconsistent. AIM: The aim of this study was to examine the efficacy and tolerability of reboxetine as an adjunct medication to antipsychotic treatment in a meta-analysis of randomized controlled trials (RCTs). METHODS: Two independent investigators extracted data for a random effects meta-analysis and assessed the quality of studies using risk of bias and the Jadad scale. Weighted and standardized mean differences (WMDs/SMDs) and risk ratio (RR)±95% confidence intervals (CIs) were calculated. RESULTS: Nine RCTs (n=630) with double-blind design were identified. Reboxetine outperformed placebo in improving negative (9 RCTs, n=602, SMD: -0.47 [95% CI: -0.87, -0.07], p=0.02; I2=82%), but not the overall, positive, and general psychopathology scores. The significant therapeutic effect on negative symptoms disappeared in the sensitivity analysis after removing an outlying study and in 50% (6/12) of the subgroup analyses. Reboxetine outperformed placebo in reducing weight (3 RCTs, n=186, WMD: -3.83 kg, p=0.04; I2=92%) and body mass index (WMD: -2.23 kg/m2, p=0.04; I2=95%). Reboxetine caused dry mouth but was associated with less weight gain overall and weight gain of ≥7% of the initial weight. All-cause discontinuation and other adverse events were similar between reboxetine and placebo. CONCLUSION: Adjunctive reboxetine could be useful for attenuating antipsychotic-induced weight gain, but it was not effective in treating psychopathology including negative symptoms in schizophrenia.

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