Can computer-assisted cognitive remediation improve employment and productivity outcomes of patients with severe mental illness? A meta-analysis of prospective controlled trials

2015 ◽  
Vol 68 ◽  
pp. 293-300 ◽  
Author(s):  
Joyce Y.C. Chan ◽  
Hoyee W. Hirai ◽  
Kelvin K.F. Tsoi
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Cognitive Remediation ◽  
Computer Assisted ◽  
Controlled Trials

The effect of rehabilitation combined with cognitive remediation on functioning in persons with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 49 (09) ◽  
pp. 1414-1425 ◽  
Author(s):  
Daniëlle van Duin ◽  
Lars de Winter ◽  
Matthijs Oud ◽  
Hans Kroon ◽  
Wim Veling ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Psychiatric Rehabilitation ◽  
Real Life ◽  
Cognitive Remediation ◽  
Beneficial Effects ◽  
Moderator Effects ◽  
Vocational Outcomes ◽  
Meta Regression Analysis

AbstractBackgroundPsychiatric rehabilitation (PR) can improve functioning in people with severe mental illness (SMI), but outcomes are still suboptimal. Cognitive impairments have severe implications for functioning and might reduce the effects of PR. It has been demonstrated that performance in cognitive tests can be improved by cognitive remediation (CR). However, there is no consistent evidence that CR as a stand-alone intervention leads to improvements in real-life functioning. The present study investigated whether a combination of PR and CR enhances the effect of a stand-alone PR or CR intervention on separate domains of functioning.MethodA meta-analysis of randomized controlled trials of PR combined with CR in people with SMI was conducted, reporting on functioning outcomes. A multivariate meta-regression analysis was carried out to evaluate moderator effects.ResultsThe meta-analysis included 23 studies with 1819 patients. Enhancing PR with CR had significant beneficial effects on vocational outcomes (e.g. employment rate: SMD = 0.41), and social skills (SMD = 0.24). No significant effects were found on relationships and outcomes of community functioning. Effects on vocational outcomes were moderated by years of education, intensity of the intervention, type of CR approach and integration of treatment goals for PR and CR. Type of PR was no significant moderator.ConclusionsAugmenting PR by adding cognitive training can improve vocational and social functioning in patients with SMI more than a stand-alone PR intervention. First indications exist that a synergetic mechanism also works the other way around, with beneficial effects of the combined intervention compared with a stand-alone CR intervention.

Nutrition interventions in people with severe mental illness: Novel strategies for addressing physical health co-morbidity in a high-risk population

2016 ◽  
Vol 33 (S1) ◽  
pp. S620-S620 ◽  
Author(s):  
S. Teasdale ◽  
P. Ward ◽  
K. Samaras ◽  
S. Rosenbaum ◽  
J. Curtis ◽  
...  
Keyword(s):  
Mental Illness ◽  
Weight Gain ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Nutrition Intervention ◽  
High Risk Population ◽  
List Type ◽  
Nutrition Interventions ◽  
Glucose Levels ◽  
Co Morbidity

IntroductionNutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.AimsA systematic review and meta-analysis was performed to assess whether nutrition interventions improve:– anthropometric and biochemical measures,– nutritional intake of people experiencing SMI.To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.MethodAn electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.ResultsFrom pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P < 0.001), reduced BMI (17 studies, g = –0.40, P < 0.001), decreased waist circumference (10 studies, g = –0.27, P < 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P < 0.001) and reductions in daily energy (–24%, P < 0.001) and sodium intakes (–26%, P < 0.001), while improving diet quality (P < 0.05).ConclusionEvidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 51 (14) ◽  
pp. 2321-2336
Author(s):  
Alice Lannes ◽  
Eric Bui ◽  
Catherine Arnaud ◽  
Jean-Philippe Raynaud ◽  
Alexis Revet
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Randomized Controlled Trials ◽  
Internalizing Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Short Term ◽  
Randomized Controlled ◽  
Post Test

AbstractChildren with parents suffering from a psychiatric disorder are at higher risk for developing a mental disorder themselves. This systematic review and meta-analysis of randomized controlled trials aims to evaluate the efficacy of psychosocial interventions to prevent negative mental health outcomes in the offspring of parents with mental illness. Eight electronic databases, grey literature and a journal hand-search identified 14 095 randomized controlled trials with no backward limit to June 2021. Outcomes in children included incidence of mental disorders (same or different from parental ones) and internalizing and externalizing symptoms at post-test, short-term and long-term follow-up. Relative risks and standardized mean differences (SMD) for symptom severity were generated using random-effect meta-analyses. Twenty trials were selected (pooled n = 2689 children). The main therapeutic approaches found were cognitive-behavioural therapy and psychoeducation. A significant effect of interventions on the incidence of mental disorders in children was found with a risk reduction of almost 50% [combined relative risk = 0.53, 95% confidence interval (CI) 0.34–0.84]. Interventions also had a small but significant effect on internalizing symptoms at post-test (SMD = −0.25, 95% CI −0.37 to −0.14) and short-term follow-up (−0.20, 95% CI −0.37 to −0.03). For externalizing symptoms, a decreasing slope was observed at post-test follow-up, without reaching the significance level (−0.11, 95% CI −0.27 to 0.04). Preventive interventions targeting the offspring of parents with mental disorders showed not only a significant reduction of the incidence of mental illness in children, but also a diminution of internalizing symptoms in the year following the intervention.

Comorbidity of Physical Disorders Among Patients With Severe Mental Illness With and Without Substance Use Disorders: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 15 (3) ◽  
pp. 192-206 ◽  
Author(s):  
Ifeoma N. Onyeka ◽  
Margrethe Collier Høegh ◽  
Eldbjørg Marie Nåheim Eien ◽  
Bright I. Nwaru ◽  
Ingrid Melle
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Substance Use ◽  
Severe Mental Illness ◽  
Substance Use Disorders ◽  
Meta Analysis ◽  
Physical Disorders

scholarly journals Pharmacological and behavioural interventions to promote smoking cessation in adults with schizophrenia and bipolar disorders: a systematic review and meta-analysis of randomised trials

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e027389 ◽  
Author(s):  
Robert Pearsall ◽  
Daniel J Smith ◽  
John R Geddes
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Smoking Cessation ◽  
Serious Mental Illness ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Controlled Trials ◽  
Major Public Health Problem ◽  
Randomised Controlled

ObjectiveSmoking in people with serious mental illness is a major public health problem and contributes to significant levels of morbidity and mortality. The aim of the review was to systematically examine the efficacy of methods used to aid smoking cessation in people with serious mental illness.MethodA systematic review and meta-analysis of randomised controlled trials to compare the effectiveness and safety of pharmacological and behavioural programmes for smoking cessation in people with serious mental illness. Electronic databases were searched for trials to July 2018. We used the Cochrane Collaboration’s tool for assessing the risk of bias.ResultsTwenty-eight randomised controlled trials were identified. Varenicline increased the likelihood of smoking cessation at both 3 months (risk ratio (RR) 3.56, 95% CI 1.82 to 6.96, p=0.0002) and at 6 months (RR 3.69, 95% CI 1.08 to 12.60, p=0.04). Bupropion was effective at 3 months (RR 3.96, 95% CI 1.86 to 8.40, p=0.0003), especially at a dose of 300 mg/day, but there was no evidence of effect at 6 months (RR 2.22, 95% CI 0.52 to 9.47, p=0.28). In one small study, nicotine therapy proved effective at increasing smoking cessation up to a period of 3 months. Bupropion used in conjunction with nicotine replacement therapy showed more effect than single use. Behavioural and bespoke interventions showed little overall benefit. Side effects were found to be low.ConclusionThe new information of this review was the effectiveness of varenicline for smoking cessation at both 3 and 6 months and the lack of evidence to support the use of both bupropion and nicotine products for sustained abstinence longer than 3 months. Overall, the review found relatively few studies in this population.

Cognitive remediation to improve the vocational outcomes of people with severe mental illness

2019 ◽  
pp. 1-23 ◽  
Author(s):  
Francisco Rodríguez Pulido ◽  
Nayra Caballero Estebaranz ◽  
Enrique González Dávila ◽  
Maria Jesús Melián Cartaya
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cognitive Remediation ◽  
Vocational Outcomes

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

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