Childhood infection and subsequent risk of psychotic disorders in adults: A systematic review and meta-analysis

BackgroundNegative symptoms observed in patients with psychotic disorders undermine quality of life and functioning. Antipsychotic medications have a limited impact. Psychological and psychosocial interventions, with medication, are recommended. However, evidence for the effectiveness of specific non-biological interventions warrants detailed examination.AimsTo conduct a meta-analytic and systematic review of the literature on the effectiveness of non-biological treatments for negative symptoms in psychotic disorders.MethodWe searched for randomised controlled studies of psychological and psychosocial interventions in psychotic disorders that reported outcome on negative symptoms. Standardised mean differences (SMDs) in values of negative symptoms at the end of treatment were calculated across study domains as the main outcome measure.ResultsA total of 95 studies met our criteria and 72 had complete quantitative data. Compared with treatment as usual cognitive–behavioural therapy (pooled SMD −0.34, 95% CI −0.55 to −0.12), skills-based training (pooled SMD −0.44, 95% CI −0.77 to −0.10), exercise (pooled SMD −0.36, 95% CI −0.71 to −0.01), and music treatments (pooled SMD −0.58, 95% CI −0.82 to −0.33) provide significant benefit. Integrated treatment models are effective for early psychosis (SMD −0.38, 95% CI −0.53 to −0.22) as long as the patients remain in treatment. Overall quality of evidence was moderate with a high level of heterogeneity.ConclusionsSpecific psychological and psychosocial interventions have utility in ameliorating negative symptoms in psychosis and should be included in the treatment of negative symptoms. However, more effective treatments for negative symptoms need to be developed.

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Psychosis in children of separated parents: A systematic review and meta-analysis

European Psychiatry ◽

10.1192/j.eurpsy.2019.15 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Luis Ayerbe ◽

María Pérez-Piñar ◽

Quintí Foguet-Boreu ◽

Salma Ayis

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Psychotic Disorders ◽

Meta Analysis ◽

Childhood Adversity ◽

Case Control ◽

Parental Separation ◽

Cross Sectional ◽

Increased Risk ◽

Cross Sectional Studies

Abstract Background. Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case–control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. Methods. Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents. Results. Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29–1.76), p < 0.001. The association remained significant when cohort, case–control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26–1.69), p < 0.001. Conclusions. Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.

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Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies

PLoS ONE ◽

10.1371/journal.pone.0257129 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257129

Author(s):

Tilahun Ali ◽

Mekonnen Sisay ◽

Mandaras Tariku ◽

Abraham Nigussie Mekuria ◽

Assefa Desalew

Keyword(s):

Systematic Review ◽

Side Effects ◽

Tardive Dyskinesia ◽

Publication Bias ◽

Psychotic Disorders ◽

Meta Analysis ◽

Extrapyramidal Side Effects ◽

Bias Analysis ◽

Pharmacological Management ◽

Early Management

Background Antipsychotic agents are the basis for the pharmacological management of acute and chronic schizophrenia, bipolar disorders, mood disorders with psychotic feature, and other psychotic disorders. Antipsychotic medication use is frequently associated with unfavorable adverse effects such as extrapyramidal side effects (EPSEs). Hence, this systematic review and meta-analysis was aimed to determine the magnitude of antipsychotic-induced EPSEs. Method A literature search was conducted using legitimate databases, indexing services, and directories including PubMed/MEDLINE (Ovid®), EMBASE (Ovid®), google scholar and WorldCat to retrieve studies. Following screening and eligibility, the relevant data were extracted from the included studies using an Excel sheet and exported to STATA 15.0 software for analyses. The Random effects pooling model was used to analyze outcome measures at a 95% confidence interval. Besides, publication bias analysis was conducted. The protocol has been registered on PROSPERO with ID: CRD42020175168. Result In total, 15 original articles were included for the systematic review and meta-analysis. The pooled prevalence of antipsychotic-induced EPSEs among patient taking antipsychotic medications was 37% (95% CI: 18–55%, before sensitivity) and 31% (95% CI: 19–44%, after sensitivity). The prevalence of antipsychotic-induced parkinsonism, akathisia, and tardive dyskinesia was 20% (95% CI: 11–28%), 11% (95% CI: 6–17%), and 7% (95% CI: 4–9%), respectively. To confirm a small-study effect, Egger’s regression test accompanied by funnel plot asymmetry demonstrated that there was a sort of publication bias in studies reporting akathisia and tardive dyskinesia. Conclusion The prevalence of antipsychotic-induced EPSEs was considerably high. One in five and more than one in ten patients experienced parkinsonism and akathisia, respectively. Appropriate prevention and early management of these effects can enhance the net benefits of antipsychotics.

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Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

Schizophrenia Bulletin ◽

10.1093/schbul/sbz030 ◽

2019 ◽

Vol 46 (1) ◽

pp. 78-90 ◽

Cited By ~ 3

Author(s):

Thomas J Reilly ◽

Vanessa C Sagnay de la Bastida ◽

Dan W Joyce ◽

Alexis E Cullen ◽

Philip McGuire

Keyword(s):

Systematic Review ◽

Menstrual Cycle ◽

Random Effects ◽

Psychotic Disorders ◽

Meta Analysis ◽

Psychotic Symptoms ◽

Cycle Phase ◽

Menstrual Cycle Phase ◽

Psychiatric Admission ◽

Admission Rates

Abstract Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31–1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

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Age at migration and the risk of psychotic disorders: a systematic review and meta‐analysis

Acta Psychiatrica Scandinavica ◽

10.1111/acps.13147 ◽

2020 ◽

Vol 141 (5) ◽

pp. 410-420

Author(s):

K. K. Anderson ◽

J. Edwards

Keyword(s):

Systematic Review ◽

Psychotic Disorders ◽

Meta Analysis ◽

Age At Migration

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The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis

BMC Psychiatry ◽

10.1186/s12888-019-2361-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Getinet Ayano ◽

Getachew Tesfaw ◽

Shegaye Shumet

Keyword(s):

Systematic Review ◽

Psychotic Disorders ◽

Meta Analysis ◽

Random Effect ◽

Homeless People ◽

Premature Mortality ◽

Final Analysis ◽

Pool Data ◽

Not Otherwise Specified ◽

Pooled Prevalence

Abstract Background Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among homeless people. This systematic review and meta-analysis aimed to estimate the pooled prevalence of schizophrenia and other psychotic disorders among homeless people. Methods PubMed, Embase, and Scopus were searched to identify pertinent studies. We used a fixed- or random-effect meta-analysis to pool data from the included studies depending on the anticipated heterogeneity. A predesigned search strategy, as well as inclusion and exclusion criteria, were used. We also performed subgroup and sensitivity analysis and Cochran’s Q- and the I2 test was employed to compute heterogeneity. Egger’s test and visual inspection of the symmetry in funnel plots were used to assess publication bias. Results Thirty-one studies involving 51,925 homeless people were included in the final analysis. The meta-analysis showed a remarkably higher prevalence of psychosis [21.21% (95% CI:13.73, 31.29), I2 = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I2 = 98.76%], schizophreniform disorder [2.48% (95% CI: 6.16, 28.11), I2 = 88.84%] schizoaffective disorder [3.53% (95% CI: 1.33, 9.05), I2 = 31.63%,] as well as psychotic disorders not otherwise specified [9% (95% CI: 6.92, 11.62), I2 = 33.38%] among homeless people. The prevalence estimate of psychosis was higher in developing (29.16%) as compared to developed (18.80%) countries. Similarly, the prevalence of schizophrenia was highest in developing (22.15%) than developed (8.83%) countries. Conclusion This systematic review and meta-analysis revealed that schizophrenia and other psychotic disorders are highly prevalent among homeless people, indicating an urgent need for studies to help develop better mechanisms of prevention, detection as well as treatment of those disorders among homeless people.

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Is there an association between cardiorespiratory fitness and stage of illness in psychotic disorders? A systematic review and meta‐analysis

Acta Psychiatrica Scandinavica ◽

10.1111/acps.13119 ◽

2019 ◽

Vol 141 (3) ◽

pp. 190-205

Author(s):

J. Heggelund ◽

D. Vancampfort ◽

M. J. Tacchi ◽

G. Morken ◽

J. Scott

Keyword(s):

Systematic Review ◽

Cardiorespiratory Fitness ◽

Psychotic Disorders ◽

Meta Analysis

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Safety and Efficacy of Acceptance and Commitment Therapy (ACT) in Schizophrenia Spectrum and Other Psychotic Disorders: Protocol for a Systematic Review and Meta-Analysis

Methods and Protocols ◽

10.3390/mps1040038 ◽

2018 ◽

Vol 1 (4) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Richard Gray ◽

Stav Hillel ◽

Ellie Brown ◽

Amal Al Ghareeb

Keyword(s):

Systematic Review ◽

Acceptance And Commitment Therapy ◽

Psychotic Disorders ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Safety And Efficacy ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

Schizophrenia Spectrum

Acceptance and commitment therapy (ACT) has been reported to be effective in the treatment of some psychiatric disorders. It remains uncertain, however, whether ACT is safe and effective in treating schizophrenia spectrum and other psychotic disorders (e.g., psychosis). This protocol describes the methodology for a systematic review and meta-analysis of the safety and efficacy of ACT in the treatment of psychosis. The review will be guided by the standards set by the Cochrane Collaboration. We will search the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica database (EMBASE), EMCARE, Education Resources Information Center (ERIC), MEDLINE, and PsycINFO databases for randomized controlled trials, whose arms are ACT and any comparator, as well as ClinicalTrials.gov, Australian New Zealand Clinical Trials Registry (ANZCTR), and Current Controlled Trials (ISRCTN), for unpublished and ongoing trials. The primary outcome will be any standard (or surrogate) measure of psychotic pathology. The meta-analysis will summarize short-term and long-term effects and different control conditions with or without treatment as usual or comparative to other interventions. In cases where heterogeneity is detected (via χ2 and I2), we will adopt the random effects model for computation.

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