The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis

BackgroundWhen used as an adjunctive with antipsychotics, certain vitamins and minerals may be effective for improving symptomatic outcomes of schizophrenia, by restoring nutritional deficits, reducing oxidative stress, or modulating neurological pathways.MethodWe conducted a systematic review of all randomized controlled trials (RCTs) reporting effects of vitamin and/or mineral supplements on psychiatric symptoms in people with schizophrenia. Random-effects meta-analyses were used to calculate the standardized mean difference between nutrient and placebo treatments.ResultsAn electronic database search in July 2016 identified 18 eligible RCTs, with outcome data for 832 patients. Pooled effects showed that vitamin B supplementation (including B6, B8 and B12) reduced psychiatric symptoms significantly more than control conditions [g= 0.508, 95% confidence interval (CI) 0.01–1.01,p= 0.047,I2= 72.3%]. Similar effects were observed among vitamin B RCTs which used intention-to-treat analyses (g= 0.734, 95% CI 0.00–1.49,p= 0.051). However, no effects of B vitamins were observed in individual domains of positive and negative symptoms (bothp> 0.1). Meta-regression analyses showed that shorter illness duration was associated with greater vitamin B effectiveness (p= 0.001). There were no overall effects from antioxidant vitamins, inositol or dietary minerals on psychiatric symptoms.ConclusionsThere is preliminary evidence that certain vitamin and mineral supplements may reduce psychiatric symptoms in some people with schizophrenia. Further research is needed to examine how the benefits of supplementation relate to nutrient deficits and the impact upon underlying neurobiological pathways, in order to establish optimal nutrient formulations for improving clinical outcomes in this population. Future studies should also explore the effects of combining beneficial nutrients within multi-nutrient formulas.

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"Effectiveness of Robotics Intervention in Education for Children and Healthcare of Elderly People: A Systematic Review and Meta-Analysis Protocol" (Preprint)

10.2196/preprints.32942 ◽

2021 ◽

Author(s):

Ramesh Athe ◽

Vidushi Varma ◽

Shivendra Pandey ◽

Ayush Gupta ◽

Sravanthi Chaitanya

Keyword(s):

Systematic Review ◽

Elder Care ◽

Meta Analysis ◽

Educational Institution ◽

Humanoid Robots ◽

Outcome Data ◽

Population Characteristics ◽

Cochrane Library ◽

Test Procedures ◽

The Impact

UNSTRUCTURED A systematic review will be carried out to examine the use of robots in early childhood and lower-level education, elder care, and learning/teaching in an educational institution(s). Present study to critically review the currently available evidence of studies carried out and look at the impact of humanoid robots on children, elder care, and education. Four major factors will be considered – the type of studies carried on the influence of robots on children’s behavior and growth, elder care, the understanding of stakeholders (parents, children, and educators) on educational robots, and finally, the reactions of the children and elderly population on robot design or presence. This review will reveal the validating of their use of robots including experimental and non-experimental trials. The steps in this process will be conducted according to the PRISMA-P (Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocols) guidelines for meta-analysis. A comprehensive review of the literature search from Medline, the Cochrane Library, Scopus, PubMed, ProQuest, and secondary references will be performed from inception to April 15, 2021. Analyses will be done to calculate summary estimates on awareness indicators and test procedures by using fixed/random-effects models. Meta-regression and covariate analyses will be performed to explore the influence of confounders on the net pooled effect. Titles and abstracts will be assessed by three independent reviewers for potential relevance. Using study-specific data forms, predetermined data will be extracted for each study. Data extracted will include: 1) study characteristics, 2) study design, 3) population characteristics, 4) details of the comparison group(s), 5) awareness indicators, 6) skills development, 7) progressive, 8) outcome data, and 9) Study year. Other classifications to be considered are a type of skill and specific age.

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Studies on PA in schizophrenia: What did we learn? What is effective?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.889 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S41-S41

Author(s):

G. de Girolamo ◽

V. Bulgari

Keyword(s):

Negative Symptoms ◽

Psychiatric Symptoms ◽

Disease Risk ◽

Meta Analysis ◽

Cardiovascular Disease Risk ◽

Well Being ◽

Cardiovascular Fitness ◽

Small Sample ◽

Attrition Rate ◽

Intention To Treat

Schizophrenia is frequently associated with abnormal physical activity (PA) per se (e.g., hypokinesia, motor retardation, etc.) or related to antipsychotic medications (e.g., extrapyramidal symptoms including bradykinesia, tremor, etc.). Daily amounts of PA for subjects diagnosed with schizophrenia tend to decrease over the illness course and contribute to metabolic and cognitive disturbances. PA intervention for schizophrenia patients may result in increased well-being, improved cognitive functioning, fewer negative symptoms and increased self-efficacy, leading to improved management of psychosocial life domains. However, PA trials conducted among people suffering from schizophrenia show several methodological limits: small sample sizes, lack of randomized patients’ allocation, heterogeneity of interventions and inappropriate outcome measures.Firth et al. (2015) have recently conducted a systematic review and meta-analysis of 11 trials on structured PA in schizophrenia (n = 659, median age of 33 years). The conclusions of this recent review are the following:– aerobic exercise (for instance exercise bike) of moderate-to-vigorous intensity done at least 90 minutes per week is effective in improving cardiovascular fitness; studies (n = 7) using VO2max as an assessment of fitness have reported clinically significant increases in VO2max, “defined as sufficient to reduce cardiovascular disease risk by 15% and mortality by 20%”;– several low-dose aerobic interventions did not shown any effect;– there was a “strong effect of exercise on total psychiatric symptoms” (both positive and negative symptoms were reduced);– total attrition rate was 32%. Group exercise showed a much lower attrition rate than solitary exercise;– caregivers’ supervision increased compliance as compared to unsupervised intervention;– in the only study that compared per-protocol and intention-to-treat analysis, a significant improvement in fitness, psychiatric symptoms and overall functioning only occurred in participants who attended > 50% of exercise sessions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The efficacy of transcranial magnetic stimulation (TMS) for negative symptoms in schizophrenia: A systematic review and meta-analysis

10.1101/2021.11.05.21265787 ◽

2021 ◽

Author(s):

Rasmus Lorentzen ◽

Tuan Dang Nguyen ◽

Alexander McGirr ◽

Fredrik Hieronymus ◽

Soren Dinesen Ostergaard

Keyword(s):

Systematic Review ◽

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Negative Symptoms ◽

Meta Analysis ◽

Preliminary Evidence ◽

Pooled Analysis ◽

P Value ◽

Number Needed To Treat ◽

Double Blind

Several trials have shown preliminary evidence for efficacy using Transcranial Magnetic Stimulation (TMS) as a treatment for negative symptoms in schizophrenia. Here, we synthesize this literature using a systematic review and quantitative meta-analysis of double-blind randomized controlled trials of TMS in patients with schizophrenia. Specifically, MEDLINE, EMBASE, Web of Science, and PsycINFO were searched for sham-controlled, randomized trials of TMS among patients with schizophrenia. The standardized mean difference (SMD, Cohen's d) with 95% confidence intervals (CI) was calculated for each study (TMS vs. sham) and pooled across studies using an inverse variance random effects model. We identified 56 studies with a total of 2550 participants that were included in the meta-analysis. The pooled analysis showed statistically significant superiority of TMS (SMD=0.37, 95%CI: 0.23; 0.52, p-value <0.00001), corresponding to a number needed to treat of 4.85. Furthermore, stratified analyses suggested that TMS targeting the left dorsolateral prefrontal cortex, using a stimulation frequency >1 Hz, and a stimulation intensity at or above the motor threshold, was most efficacious. There was, however, substantial heterogeneity and high risk of bias among the included studies. In conclusion, TMS appears to be an efficacious treatment option for patients with schizophrenia suffering from negative symptoms, but the optimal TMS parameters have yet to be resolved.

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Abstract 20116: The Impact of Atrial Fibrillation Type on the Risk of Thromboembolism, Mortality and Bleeding: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.132.suppl_3.20116 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Anand Ganesan ◽

Derek Chew ◽

Trent Hartshorne ◽

Joseph B Selvanayagam ◽

Philip Aylward ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Risk Ratio ◽

Meta Analysis ◽

Case Series ◽

Outcome Data ◽

Risk Models ◽

Thromboembolic Risk ◽

All Cause Mortality ◽

The Impact

Introduction: Thromboembolic risk stratification schemes and clinical guidelines for atrial fibrillation regard risk as independent of classification into paroxysmal (PAF) and nonparoxysmal atrial fibrillation (NPAF). The aim of the current study was to conduct a systematic review and meta-analysis evaluating the impact of AF type on thromboembolism, bleeding and mortality. Hypothesis: AF type would predict rates of thromebolism, mortality and bleeding. Methods: Pubmed was searched for randomized controlled trials, cohort studies, and case series reporting prospectively collected clinical outcomes stratified by AF type. The incidence of thromboembolism, mortality and bleeding was extracted. Results: AF clinical outcome data was extracted from 12 studies containing 99,996 patients. The pooled unadjusted risk ratio (RR) for thromboembolism in NPAF vs. PAF was RR 1.339 (95% CI: 1.140-1.644, P<0.001). In studies providing estimates of thromboembolism risk adjusted for baseline clinical risk factors, the pooled adjusted hazard ratio (HR) in NPAF vs. PAF was HR 1.384 (95% CI, 1.191-1.608, P<0.001). The pooled unadjusted risk ratio for all-cause mortality in NPAF vs. PAF was RR 1.462 (95% CI: 1.255-1.703 P<0.001). The pooled adjusted HR for all-cause mortality in NPAF vs. PAF was HR 1.217 (95% CI: 1.085-1.365, P<0.001. Rates of bleeding in NPAF and PAF were similar, unadjusted RR 1.00 (95% CI 0.919-1.087, P=0.994), pooled adjusted HR 1.025 (95% CI: 0.898-1.170, P=0.715). Conclusions: These data suggest a need for re-evaluation of the paradigm of thromboembolic risk equivalence between PAF and NPAF, and emphasize AF type as a powerful predictor of AF-related morbidity and mortality. Future studies exploring integration of AF type into thromboembolic risk models are needed.

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Compensatory Interventions for Cognitive Impairments in Psychosis: A Systematic Review and Meta-Analysis

Schizophrenia Bulletin ◽

10.1093/schbul/sbz134 ◽

2020 ◽

Vol 46 (4) ◽

pp. 869-883 ◽

Cited By ~ 1

Author(s):

Kelly Allott ◽

Kristi van-der-EL ◽

Shayden Bryce ◽

Emma M Parrish ◽

Susan R McGurk ◽

...

Keyword(s):

Systematic Review ◽

Psychiatric Symptoms ◽

Meta Analysis ◽

Risk Of Bias ◽

Effect Sizes ◽

Medium Effect ◽

Post Intervention ◽

Psychosocial Disability ◽

The Impact

Abstract Objective Cognitive compensatory interventions aim to alleviate psychosocial disability by targeting functioning directly using aids and strategies, thereby minimizing the impact of cognitive impairment. The aim was to conduct a systematic review and meta-analysis of cognitive compensatory interventions for psychosis by examining the effects on functioning and symptoms, and exploring whether intervention factors, study design, and age influenced effect sizes. Methods Electronic databases (Ovid Medline, PsychINFO) were searched up to October 2018. Records obtained through electronic and manual searches were screened independently by two reviewers according to selection criteria. Data were extracted to calculate estimated effects (Hedge’s g) of treatment on functioning and symptoms at post-intervention and follow-up. Study quality was assessed using Cochrane Collaboration’s risk of bias tool. Results Twenty-six studies, from 25 independent randomized controlled trials (RCTs) were included in the meta-analysis (1654 participants, mean age = 38.9 years, 64% male). Meta-analysis revealed a medium effect of compensatory interventions on functioning compared to control conditions (Hedge’s g = 0.46, 95% CI = 0.33, 0.60, P < .001), with evidence of relative durability at follow-up (Hedge’s g = 0.36, 95% CI = 0.19, 0.54, P < .001). Analysis also revealed small significant effects of cognitive compensatory treatment on negative, positive, and general psychiatric symptoms, but not depressive symptoms. Estimated effects did not significantly vary according to treatment factors (ie, compensatory approach, dosage), delivery method (ie, individual/group), age, or risk of bias. Longer treatment length was associated with larger effect sizes for functioning outcomes. No evidence of publication bias was identified. Conclusion Cognitive compensatory interventions are associated with robust, durable improvements in functioning in people with psychotic illnesses.

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The Therapeutic Potential of Carnosine/Anserine Supplementation against Cognitive Decline: A Systematic Review with Meta-Analysis

Biomedicines ◽

10.3390/biomedicines9030253 ◽

2021 ◽

Vol 9 (3) ◽

pp. 253 ◽

Cited By ~ 3

Author(s):

Giuseppe Caruso ◽

Justyna Godos ◽

Sabrina Castellano ◽

Agnieszka Micek ◽

Paolo Murabito ◽

...

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Cognitive Decline ◽

Clinical Studies ◽

Therapeutic Potential ◽

Meta Analysis ◽

Preliminary Evidence ◽

Elderly Subjects ◽

Neuroprotective Effects ◽

The Impact

Carnosine is a natural occurring endogenous dipeptide that was proposed as an anti-aging agent more than 20 years ago. Carnosine can be found at low millimolar concentrations at brain level and different preclinical studies have demonstrated its antioxidant, anti-inflammatory, and anti-aggregation activity with neuroprotective effects in animal models of Alzheimer’s disease (AD). A selective deficit of carnosine has also been linked to cognitive decline in AD. Different clinical studies have been conducted to evaluate the impact of carnosine supplementation against cognitive decline in elderly and AD subjects. We conducted a systematic review with meta-analysis, in accordance with the PRISMA guidelines coupled to the PICOS approach, to investigate the therapeutic potential of carnosine against cognitive decline and depressive symptoms in elderly subjects. We found five studies matching the selection criteria. Carnosine/anserine was administered for 12 weeks at a dose of 1 g/day and improved global cognitive function, whereas no effects were detected on depressive symptoms. These data suggest a preliminary evidence of clinical efficacy of carnosine against cognitive decline both in elderly subjects and mild cognitive impairment (MCI) patients, although larger and long-term clinical studies are needed in MCI patients (with or without depression) to confirm the therapeutic potential of carnosine.

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