FC16-05 - Efficacy of social cognitive remediation in schizophrenia patients: a meta-analysis including 22 RCTS

2011 ◽  
Vol 26 (S2) ◽  
pp. 1908-1908
Author(s):  
D.R. Mueller ◽  
S.J. Schmidt ◽  
V. Roder

IntroductionToday there is an increased interest from clinicians and researchers in social cognition as a treatment objective for schizophrenia patients.ObjectivesDuring the last years, several new Social Cognitive Remediation (SCR) approaches were developed. SCR directly intervene in individual or multiple social cognitive domains declared by the NIMH-MATRICES-Initiative. Some of these approaches integrate social cognitive interventions with therapeutic components intended to ameliorate neurocognitive and social skills or with work rehabilitation.AimsUntil today no quantitative review to evaluate the efficacy of SCR has been presented.Methods22 randomized-controlled trials (RCTs) were identified and included in a meta-analysis. Based on the outcome variables from each study, effect sizes (ES) between SCR and control groups were calculated.ResultsOver an average length of more than 20 weeks a significant global therapy effect of SCR compared to controls was evident (average ES of all conducted variables). Significant effects were found in the proximal outcome addressing social cognition and specifically in the domains of emotional processes, social perception and ToM. Additionally, the neurocognitive area showed significant evidence of amelioration compared with the control groups. More distal effects were found for psychopathology and social functioning. The global therapy effect could be maintained during a mean follow-up period of 10 months. The setting, the type of control groups and the type of intervention in the experimental group were identified as moderators.ConclusionsThe results support strong empirical evidence that SCR has a broad effect on various areas of functioning and symptoms relevant in schizophrenia.

2019 ◽  
Author(s):  
Siobhan Hugh-Jones ◽  
Sophie Beckett ◽  
Pavan Mallikarjun

Schools are promising sites for the delivery of prevention and early intervention programs to reduce child and adolescent anxiety. It is unclear whether universal or targeted approaches are most effective. This review and meta-analysis examines the effectiveness of school-based indicated interventions and was registered with PROSPERO [CRD42018087628].MEDLINE, EMBASE, PsycINFO and the Cochrane Library were searched for randomised controlled trials comparing indicated school programs for child and adolescent anxiety to active or inactive control groups. Twenty original studies, with 2076 participants, met the inclusion criteria and 18 were suitable for meta-analysis. Sub-group and sensitivity analyses explored intervention intensity, delivery agent and control type. A small beneficial effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test (g = -0.28, CI = -0.50, -0.05, k= 18). The small effect was maintained at 6 (g = -0.35, CI= -0.58, -0.13, k = 9) and 12 months (g = -0.24, CI = -0.48, 0.00, k = 4). Based on two studies, >12 month effects were very small (g = -0.01, CI= -0.38, 0.36). No differences were found based on intervention intensity, delivery agent and control type. There was evidence of publication bias and a relatively high risk of contamination in studies. Findings support the value of school based indicated programs for child and adolescent anxiety. Effects at 12 months outperform many universal programs. High quality, randomised controlled and pragmatic trials are needed, with attention control groups and beyond 12 month diagnostic assessments are needed.


2017 ◽  
Vol 23 (7) ◽  
pp. 577-583 ◽  
Author(s):  
Beatrice Frajo-Apor ◽  
Georg Kemmler ◽  
Silvia Pardeller ◽  
Markus Huber ◽  
Christian Macina ◽  
...  

AbstractObjectives:Social cognitive deficits have been discussed to be endophenotypes for schizophrenia and other serious mental illnesses. The current study aimed to assess emotional intelligence (EI) in unaffected siblings of schizophrenia patients to investigate its potential role as endophenotype for schizophrenia.Methods:EI was measured in 56 schizophrenia patients, 57 unaffected siblings, and 127 healthy control subjects by using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). In addition, non-social cognition was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS). Linear mixed models with compound symmetric correlation structure were used for of the three groups with respect to EI and non-social cognition.Results:Schizophrenia patients showed significantly lower overall EI and performed significantly worse in three out of four MSCEIT branches compared to unaffected siblings and control subjects, whereas the two latter groups had comparable EI levels. Similar performance patterns (patients<unaffected siblings=control subjects) were found with respect to non-social cognition. Solely in the “Tower of London” test, siblings achieved significantly lower task scores compared to control subjects.Conclusions:Based on our results, EI as measured with the MSCEIT does not seem to represent a marker of risk for schizophrenia. Further investigations should concentrate on other EI measures to reassess this finding. (JINS, 2017,23, 577–583)


2021 ◽  
Author(s):  
Chun Chen ◽  
ZeMei Zhou ◽  
Jing Zhang

Abstract Background: Since December 2019, COVID-19 has spread to the world which leads to a global health threat. We aimed to investigate the effectiveness of tocilizumab on COVID-19 patients.Methods: We systematically searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and WHO international Clinical Trials Registry Platform (ICTRP) from their inception to March 10, 2021 for randomized controlled trials (RCTs) on tocilizumab supplementation in adults with COVID-19 disease. The primary outcomes were mortality at 28-30 day and 60-day, incidence of mechanical ventilation (MV), composite outcome of death or MV, time to hospital discharge, and intensive care unit (ICU) admissions. A random-effects meta-analysis model was used to pool studies. Results: Eleven studies with a total of 6,579 patients were included in our meta-analysis, of which 3,406 and 3,173 were respectively assigned to the tocilizumab and control groups. Tocilizumab could significantly reduce 28-30 day mortality (RR = 0.89, 95% CI 0.80-0.99, P = 0.04), incidence of MV (RR= 0.79, 95% CI 0.71-0.89, P = 0.0001), composition outcome of MV or death (RR = 0.81, 95% CI 0.72-0.90, P = 0.0002), time to hospital discharge (HR = 1.30, 95% CI 1.16-1.45, P < 0.00001 ), ICU admissions (RR = 0.64, 95% CI 0.47-0.88, P = 0.006), serious infection (RR = 0.61, 95% CI 0.40-0.94, P = 0.02) and events of serious adverse advents (RR = 0.64, 95% CI 0.47-0.86, P = 0.004). There was no significant difference between tocilizumab and control groups in 60-day mortality and adverse events (AEs).Conclusions: Tocilizumab could reduce the short-term mortality, incidence of MV, composite outcome of death or MV, ICU admissions, serious infection and events of serious adverse advents, and shorten the time to hospital discharge in hospitalized patients with COVID-19. The optimal effective dose needs to be confirmed by further studies.


Author(s):  
O. Lazurenko

The model and the logic of empirical research are determined. The experimental study of emotional competence is presented. A general description of the subjects is systematized. The results of the ascertaining experiment are presented. The author conducted her research in several directions. This approach allowed the researcher to present the quantitative characteristics of emotional intelligence on all scales and subscales in details. On this basis, the author makes a detailed qualitative analysis of the manifestation of the studied ability in future doctors. Besides, after conduction of the research, the author makes conclusion that students' ability to understand and manage other people's emotions and the ability to understand their own emotions and manage them are not formed enough. And these make impossible the success of the future professional activities of a doctor. The author makes conclusion that the development of emotional competence of students of medical universities can be formed by introducing special courses, educational and developmental training programs into the educational process. The correlation analysis allowed the author to empirically confirm the correct determination of the content of the basic components of the future doctor’s emotional competence. Besides, it is proved that the parameters of the social, cognitive, regulatory, empathic components of emotional competence significantly correlate with each other. The received results confirmed that during first year medical students of the experimental and control groups have the same positions of the level of development of emotional competence. And any significant statistical differences in its manifestation were not found among students of the experimental and control groups. Moreover, the received results at ascertaining stage of the study showed the insufficient level of development of the components of emotional competence among students of medical faculty. This led to the creation of a program for the formation of the emotional competence of a future doctor in the process of training in a higher medical school


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
James S McKinney ◽  
William J Kostis ◽  
John B Kostis

Introduction--- Statin therapy decreases the risk of myocardial infarction and ischemic stroke. However, an increased risk of intracerebral hemorrhage (ICH) has been observed in some studies. To investigate this issue we performed a meta-analysis of all randomized controlled trials (RCTs) using statins that reported ICH. Methods--- We performed a Medline literature search through March 18, 2011 and identified additional RCTs by reviewing reference lists of retrieved studies and prior meta-analyses. All RCTs of statin therapy versus placebo or high dose versus low dose statin therapy that reported ICH or hemorrhagic stroke were included. The primary outcome variable was ICH. 26 RCTs were included. All analyses used random effects models and heterogeneity was not observed in any of the analyses. Results--- 84 831 subjects were included in the Active group, and 84 851 in the Control group. A trend towards a higher incidence of ICH was observed in the Active treatment group compared to Control (OR = 1.15; 95% CI = 0.91 to 1.45, p =0.24) (Figure). Significant relationships were not observed between the log OR for ICH with achieved LDL in the Active group (slope = 0.0002; 95% CI = -0.0098 to 0.0101, p =0.96) or with the difference in LDL drop between the Active and Control groups (slope = 0.0030; 95% CI = -0.0089 to 0.0149, p =0.62). Total stroke (OR = 0.84; 95% CI = 0.78 to 0.91, p <0.001) and all-cause mortality (OR = 0.91; 95% CI = 0.86 to 0.96, p <0.001) were significantly reduced in the Active group. A significant relationship between all-cause mortality and the difference in LDL drop between the Active and Control groups was observed (slope = -0.0030; 95% CI = -0.0009 to -0.0051, p<0.005). There was not evidence of publication bias in this meta-analysis. Conclusions--- Active therapy was associated with a trend towards increased ICH in this meta-analysis of 26 RCTs of statin therapy. However, this risk does not appear to be related to the degree of decline or achieved LDL. The risk of ICH is offset by a significant reduction in ischemic stroke and all-cause mortality and should not dissuade practitioners from prescribing statins in otherwise appropriate patients.


2020 ◽  
pp. 108705472090651 ◽  
Author(s):  
Sarah Morris ◽  
Jade Sheen ◽  
Mathew Ling ◽  
Denise Foley ◽  
Emma Sciberras

Objective: Peer social functioning difficulties characteristic of ADHD persist into adolescence, but the efficacy of interventions for this age group remains unclear. Method: A systematic search of nonpharmacological interventions for adolescents with ADHD (10–18 years) identified 11 trials addressing social functioning, of which eight were included in meta-analyses. Results: Random effects meta-analyses of four randomized trials found no differences in social functioning between treatment and control groups by parent- ( g = −0.08 [−0.34, 0.19], k = 4, N = 354) or teacher-report ( g = 0.17 [−0.06, 0.40], k = 3, N = 301). Meta-analyses of nonrandomized studies indicated participants’ social functioning improved from baseline to postintervention by parent-report, but not teacher- or self-report. All trials had a high risk of bias. Conclusion: These results highlight the paucity of research in this age group. There is little evidence that current interventions improve peer social functioning. Clearer conceptualizations of developmentally relevant targets for remediation may yield more efficacious social interventions.


2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Julien Dubreucq ◽  
Franck Gabayet ◽  
Bernard Ycart ◽  
Megane Faraldo ◽  
Fanny Melis ◽  
...  

Abstract Background. Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed. Methods. we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment. Results. Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up. Conclusions. Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S52-S52
Author(s):  
Tommaso Accinni ◽  
Marianna Frascarelli ◽  
Antonino Buzzanca ◽  
Luca Carlone ◽  
Francesco Ghezzi ◽  
...  

Abstract Background 22q11DS is the most important genetic risk factor for schizophrenia: up to 28% of these subjects develop psychosis in adulthood. At present this syndrome represents the strongest biological model to investigate neurobiological underpinnings of schizophrenia. We expected Theory of Mind impairments in subjects at risk for psychosis (22q11DS) and more severe impairments in subjects with an established psychotic disorder. Furthermore we sought to investigate eventual correlations between social cognition and self-esteem levels, hypothesizing that both would be impaired in psychotic groups. Methods Data come from Italian Network for Research on Psychoses for the Schizophrenic (SCZ, N=260) and Control groups (HC, N=111). 22q11DS psychotic (22q11DS_SCZ, N=17) and non-psychotic patients (22q11DS, N=46) were enrolled at Policlinico Umberto I, in Rome. The Awareness and Social Inference Test (TASIT) and Self-Esteem Rating Scale (SERS) were administered. Results The three main TASIT variables, Emotion Recognition, Minimal Social Inference and Enriched Social Inference, showed no different scores between the three clinical groups, which were significantly lower respect to the control group. The SERS total score showed no significant differences between clinical groups but was for all three significantly lower than control group score. No significant correlation was observed between SERS and TASIT scores for clinical groups. Discussion Social Cognition impairments are present in 22q11DS at the same extent as in idiopathic schizophrenia, and thus they represent an endophenotype of psychosis. A low Self-Esteem, even though associated to psychosis, does not affect neurocognitive process, impaired on a neurobiological basis.


2020 ◽  
pp. oemed-2020-106418
Author(s):  
Chen Chen ◽  
Felicia Wu

ObjectivesMethicillin-resistant Staphylococcus aureus (MRSA) is an increasing public health concern worldwide. The objective of this study was to calculate a summary odds ratio (OR) of livestock-associated MRSA colonisation and infection in humans, and to determine specific risk factors in livestock production contributing to MRSA colonisation.MethodsWe screened PubMed and Embase for studies published from 2005 to 2019 inclusive, reporting livestock-associated (LA)-MRSA colonisation and infection among livestock workers/veterinarians, their families, and community members not regularly exposed to livestock. The primary outcome of interest was the OR of LA-MRSA colonisation comparing exposed and control groups. Quality was assessed according to the Newcastle-Ottawa quality assessment scale. A meta-analysis using a random-effects model was conducted to calculate a pooled OR. The heterogeneity in the meta-analysis was assessed using the I² method, and publication bias was evaluated using funnel plots.ResultsA total of 3490 studies were identified by the search, with 37 studies including 53 matched exposed-control groups and 14 038 participants eligible for the meta-analysis. The pooled OR for LA-MRSA among livestock workers and veterinarians is 9.80 (95% CI 6.89 to 13.95; p=0.000; I2=73.4), with no significant publication bias (Egger’s p=0.66). The OR for swine workers was highest at 15.41 (95% CI 9.24 to 25.69), followed by cattle workers (11.62, 95% CI 4.60 to 29.36), veterinarians (7.63, 95% CI 3.10 to 18.74), horse workers (7.45, 95% CI 2.39 to 23.25), livestock workers (5.86, 95% CI 1.14 to 30.16), poultry workers (5.70, 95% CI 1.70 19.11), and industrial slaughterhouse workers (4.69, 95% CI 1.10 to 20.0).ConclusionsLivestock workers, particularly swine farmers, are at significantly higher risk for LA-MRSA colonisation and subsequent infection. These results support the need for preventive practices to reduce LA-MRSA risk among those who handle and treat livestock.Trial registration numberCRD42019120403.


Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 693 ◽  
Author(s):  
Cheng ◽  
Chang ◽  
Wang ◽  
Hsiao ◽  
Lai ◽  
...  

Background and objectives: High-flow nasal cannula (HFNC) can be used as a respiratory support strategy for patients with acute respiratory failure (ARF). However, no clear evidence exists to support or oppose HFNC use in immunocompromised patients. Thus, this meta-analysis aims to assess the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on the outcomes in immunocompromised patients with ARF. The Pubmed, Embase and Cochrane databases were searched up to November 2018. Materials and Methods: Only clinical studies comparing the effect of HFNC with COT or NIV for immunocompromised patients with ARF were included. The outcome included the rate of intubation, mortality and length of stay (LOS). Results: A total of eight studies involving 1433 immunocompromised patients with ARF were enrolled. The pooled analysis showed that HFNC was significantly associated with a reduced intubation rate (risk ratio (RR), 0.83; 95% confidence interval (CI), 0.74–0.94, I2 = 0%). Among subgroup analysis, HFNC was associated with a lower intubation rate than COT (RR, 0.86; 95% CI, 0.75–0.95, I2 = 0%) and NIV (RR, 0.59; 95% CI, 0.40–0.86, I2 = 0%), respectively. However, there was no significant difference between HFNC and control groups in terms of 28-day mortality (RR, 0.78; 95% CI, 0.58–1.04, I2 = 48%), and intensive care unit (ICU) mortality (RR, 0.87; 95% CI, 0.73–1.05, I2 = 57%). The ICU and hospital LOS were similar between HFNC and control groups (ICU LOS: mean difference, 0.49 days; 95% CI, −0.25–1.23, I2 = 69%; hospital LOS: mean difference, −0.12 days; 95% CI, −1.86–1.61, I2 = 64%). Conclusions: Use of HFNC may decrease the intubation rate in immunocompromised patients with ARF compared with the control group, including COT and NIV. However, HFNC could not provide additional survival benefit or shorten the LOS. Further large, randomized controlled trials are needed to confirm these findings.


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