Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials

Background.Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs).Method.A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use of a Boolean expression, articles were included if they: (i) investigated mental health outcomes; (ii) had a design consistent with RCTs. We excluded protocols involving intercessory prayer or distance healing. The study was conducted in two phases by reading: (1) title and abstracts; (2) full papers and assessing their methodological quality. Then, a meta-analysis was carried out.Results.Through this method, 4751 papers were obtained, of which 23 remained included. The meta-analysis showed significant effects of RSI on anxiety general symptoms (p < 0.001) and in subgroups: meditation (p < 0.001); psychotherapy (p = 0.02); 1 month of follow-up (p < 0.001); and comparison groups with interventions (p < 0.001). Two significant differences were found in depressive symptoms: between 1 and 6 months and comparison groups with interventions (p = 0.05). In general, studies have shown that RSI decreased stress, alcoholism and depression.Conclusions.RCTs on RSI showed additional benefits including reduction of clinical symptoms (mainly anxiety). The diversity of protocols and outcomes associated with a lack of standardization of interventions point to the need for further studies evaluating the use of religiosity/spirituality as a complementary treatment in health care.

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Mental health quality of life after bariatric surgery: A systematic review and meta-analysis of randomized clinical trials

Clinical Obesity ◽

10.1111/cob.12290 ◽

2018 ◽

Vol 9 (1) ◽

pp. e12290 ◽

Cited By ~ 15

Author(s):

Alejandro Szmulewicz ◽

Kerollos N. Wanis ◽

Ashley Gripper ◽

Federico Angriman ◽

Jeff Hawel ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Systematic Review ◽

Bariatric Surgery ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Health Quality ◽

Health Quality Of Life

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Impact of opioid agonists on mental health in substitution treatment for opioid use disorder: A systematic review and Bayesian network meta-analysis of randomized clinical trials

10.1101/2020.07.04.20146506 ◽

2020 ◽

Author(s):

Ehsan Moazen-Zadeh ◽

Kimia Ziafat ◽

Kiana Yazdani ◽

Mostafa Mamdouh ◽

James Wong ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Clinical Trials ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Opioid Use Disorder ◽

Substitution Treatment ◽

Opioid Use ◽

Psychosocial Services ◽

Opioid Medications

AbstractObjectiveThere is a dearth of high-quality systematic evidence on the impact of opioid substitution medications on mental health. We compared mental health outcomes between opioid medications and placebo/waitlist, and between different opioids.MethodsThis systematic review and meta-analysis of randomized clinical trials (RCTs) was pre-registered at PROSPERO (CRD42018109375). Embase, MEDLINE, PsychInfo, CINAHL Complete, and Web of Science Core Collection were searched from inception to May 2020. RCTs were included if they compared opioid agonists with each other or with a placebo/waitlist in substitution treatment of patients with opioid use disorder, and reported at least one mental health outcome on a span of more than 1-month post baseline. Studies with psychiatric care, adjunct psychotropic medications, or unbalanced psychosocial services were excluded. Primary outcomes were comparison of depressive symptoms and overall mental health between opioids and placebo/waitlist. Random effects model was used for all the meta-analysis.ResultsNineteen studies were included in the narrative synthesis and 15 in the quantitative synthesis. Hydromorphone, diacetylmorphine (DAM), methadone, slow-release oral morphine, buprenorphine, and placebo/waitlist were among the included interventions. Based on network meta-analysis for primary outcomes, buprenorphine (SMD (CI95%)= −0.61 (−1.20, −0.11)), DAM (−1.40 (−2.70, −0.23)), and methadone (−1.20 (−2.30, −0.11)) were superior to waitlist/placebo on overall mental health. Further direct pairwise meta-analysis indicated that overall mental health improved more in DAM compared to methadone (−0.23 (−0.34, −0.13)).ConclusionsIt appears that opioid medications improve mental health independent of psychosocial services. Potential contribution of other factors needs to be further investigated.

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Systematic review and meta-analysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention

American Heart Journal ◽

10.1016/j.ahj.2007.12.024 ◽

2008 ◽

Vol 155 (6) ◽

pp. 1081-1089 ◽

Cited By ~ 78

Author(s):

Giuseppe G.L. Biondi-Zoccai ◽

Marzia Lotrionte ◽

Matteo Anselmino ◽

Claudio Moretti ◽

Pierfrancesco Agostoni ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Percutaneous Coronary Intervention ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

The Impact

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Effect of Pycnogenol on Blood Pressure: Findings From a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Studies

Angiology ◽

10.1177/0003319719889428 ◽

2019 ◽

Vol 71 (3) ◽

pp. 217-225 ◽

Cited By ~ 1

Author(s):

Federica Fogacci ◽

Giuliano Tocci ◽

Amirhossein Sahebkar ◽

Vivianne Presta ◽

Maciej Banach ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Clinical Trials ◽

Clinical Studies ◽

Randomized Clinical Trials ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Double Blind ◽

Double Blind Placebo ◽

The Impact

Results of previous clinical trials evaluating the effect of pycnogenol supplementation on blood pressure (BP) are controversial. Therefore, we aimed to assess the impact of pycnogenol on BP through a systematic review of literature and meta-analysis of available randomized, double-blind, placebo-controlled clinical studies (randomized clinical trials [RCTs]). Literature search included SCOPUS, PubMed-Medline, ISI Web of Science, and Google Scholar databases up to January 10, 2019 to identify RCTs investigating the impact of pycnogenol on BP. Two investigators independently extracted data on study characteristics, methods, and outcomes. This systematic review and meta-analysis is registered in International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42018112172. Overall, the impact of pycnogenol on BP was reported in 7 trials involving 626 participants. Meta-analysis did not suggest any significant improvement in systolic BP (weighted mean difference [WMD]: −0.028 mm Hg; 95% confidence interval [CI]: −0.182 to 0.127; P = .726; I2 = 46%), diastolic BP (WMD: −0.144 mm Hg; 95% CI: −0.299 to 0.010; P = .067; I2 = 0%), mean arterial pressure (WMD: −0.091 mm Hg; 95% CI: −0.246 to 0.063; P = .246; I2 = 0%), and pulse pressure (WMD: −0.003 mm Hg; 95% CI: −0.151 to 0.158; P = .966; I2 = 0%) following pycnogenol treatment. Results persisted in the leave-one-out sensitivity analysis. Therefore, the present meta-analysis does not suggest any significant effect of pycnogenol on BP.

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