scholarly journals Towards personalising treatment: a systematic review and meta-analysis of face-to-face efficacy moderators of cognitive-behavioral therapy and interpersonal psychotherapy for major depressive disorder

2019 ◽  
Vol 49 (16) ◽  
pp. 2657-2668
Author(s):  
Aoife Whiston ◽  
Claudi L. H. Bockting ◽  
Maria Semkovska
Keyword(s):  
Systematic Review ◽  
Antidepressant Treatment ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Interpersonal Psychotherapy ◽  
Cochrane Library ◽  
Comparable Efficacy ◽  
Face To Face ◽  
Analytic Review

AbstractBackgroundConsistent evidence suggests that face-to-face cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT) may be equally effective depression treatments. Current clinical research focuses on detecting the best predictors-moderators of efficacy to guide treatment personalisation. However, individual moderator studies show inconsistent findings. This systematic review and meta-analysis aimed to compare the efficacy of CBT and IPT, including combined treatment with antidepressants for depression, and evaluate the predictive power of demographic, clinical presentation and treatment characteristics moderators for both therapies.MethodsPsycArticles, PsycINFO, PubMed and Cochrane Library were systematically searched through December 2017 for studies that have assessed individuals with major depression receiving either CBT or IPT in a face-to-face format both at pre- and post-treatment. Random-effects moderator meta-analyses were conducted.ResultsIn total 168 samples from 137 studies including 11 374 participants qualified for the meta-analytic review. CBT and IPT were equally effective across all but one prespecified moderators. For psychotherapy delivered without concomitant antidepressant treatment [antidepressant medications (ADMs)], CBT was superior to IPT (g = 1.68, Qbetweenp = 0.037). Within-CBT moderator analyses showed that increased CBT efficacy was associated with lower age, high initial depression severity, individual format of administration and no adjunctive ADMs. Within-IPT analyses showed comparable efficacy across all moderators.ConclusionsClinical guidance around combined treatment (psychotherapy plus ADMs) should be reconsidered. CBT alone is superior to IPT alone and to combined treatment, while IPT alone is non-inferior to combined treatment. More research is needed to assess the moderating effect of older age and number of previous episodes on IPT efficacy.

scholarly journals Non-Pharmacological Interventions for Post-Stroke Fatigue: Systematic Review and Network Meta-Analysis

2020 ◽  
Vol 9 (3) ◽  
pp. 621 ◽  
Author(s):  
Ya Su ◽  
Michiko Yuki ◽  
Mika Otsuki
Keyword(s):  
Systematic Review ◽  
Health Management ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions ◽  
Post Stroke ◽  
Equivalent Efficacy ◽  
Fatigue Severity

Post-stroke fatigue (PSF) is one of the most serious sequelae, which often interferes with the rehabilitation process and impairs the functional recovery of patients. Due to insufficient evidence, it is unclear which specific pharmacological interventions should be recommended. Therefore, in this paper, we compare the effectiveness of non-pharmacological interventions in PSF. A systematic review and network meta-analysis of randomized controlled trials were performed using EMBASE, MEDLINE, CINAHL, Cochrane library, ClinicalTrials.gov, CNKI, and CQVIP, from inception to January 2018, in the English and Chinese languages. RCTs involving different non-pharmacological interventions for PSF with an outcome of fatigue measured using the Fatigue Severity Scale were included. Multiple intervention comparisons based on a Bayesian network are used to compare the relative effects of all included interventions. Ten RCTs with eight PSF non-pharmacological interventions were identified, comprising 777 participants. For effectiveness, most interventions did not significantly differ from one another. The cumulative probabilities of the best non-pharmacological intervention for fatigue reduction included Community Health Management (CHM), followed by Traditional Chinese Medicine (TCM) and Cognitive Behavioral Therapy (CBT). Network meta-analysis based on data from the selected RCTs indicated that the eight PSF non-pharmacological interventions shared equivalent efficacy, but CHM, TCM, and CBT showed potentially better efficacy. In the future, fatigue needs to be recognized and more accurate assessment methods for PSF are required for diagnosis and to develop more effective clinical interventions.

scholarly journals The Effectiveness of Interpersonal Psychotherapy Versus Cognitive Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Qihang Xie ◽  
Pengcheng Yi ◽  
Xinyang Hu ◽  
Jianxiang Lei ◽  
Jiacheng Kong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Interpersonal Psychotherapy ◽  
Cognitive Behavioral ◽  
Secondary Outcome ◽  
Future Research

Abstract Purpose: Interpersonal psychotherapy (IPT) has been proposed as a treatment strategy for eating disorders (EDs). However, cognitive behavioral therapy (CBT) is the treatment more effectively and widely used than IPT. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness of IPT versus CBT on EDs. Methods: We systematically searched PubMed, Embase, Medline, Cochrane, Web of Science, and the Clinical Trials Database for RCTs that compared IPT and CBT.Results: Of 468 studies initially identified, 10 were suitable for incorporation into our meta-analysis (N = 833 participants). In those studies, IPT and CBT had comparable effects in terms of primary outcome (i.e., ED score) (SMD = 0.08), while IPT had a better effect in terms of secondary outcome (i.e., Inventory of Interpersonal Problems) (SMD = 0.32) than CBT. Compared with CBT, IPT had a better treatment effect for ED populations with lower Body Mass Index (SMD = 0.27) and age (SMD = 0.43). IPT and CBT both had follow-up effects of pre-test and follow-up comparison after fewer than 6 months (SMD = 1.61, 1.83), 6–12 months (SMD =1.48, 1.65), and more than 12 months (SMD = 1.29, 1.33). At the same time, only CBT showed a dose-response relationship trend (β = 0.017, p = 0.067). Conclusion: The meta-analysis provided clear evidence that IPT is an effective treatment measure for patients with EDs. This review also suggested that future research is needed to determine the effects of IPT in the treatment of EDs.Level of evidence Level I, systematic review and meta-analysis.

Teleconsultation in orthopaedic surgery: A systematic review and meta-analysis of patient and physician experiences

2020 ◽  
pp. 1357633X2095099
Author(s):  
Christina Melian ◽  
David Kieser ◽  
Christopher Frampton ◽  
Michael C Wyatt
Keyword(s):  
Systematic Review ◽  
Healthcare Costs ◽  
Orthopaedic Surgery ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Office Visits ◽  
Face To Face ◽  
Significant Difference ◽  
Management Plans ◽  
Length Of Visit

Introduction The primary purpose of this review was to evaluate patient and physician preference and satisfaction for teleconsultation in orthopaedic surgery compared to traditional face-to-face consultation. In addition, we evaluated the effects of teleconsultation on patient length of visit, healthcare costs, range of motion (ROM), pain, quality of life (QOL), and ongoing management plans. Methods A systematic review of MEDLINE, Embase, Web of Science, and Cochrane Library was conducted according to PRISMA guidelines. Randomised control trials and case control studies comparing teleconsultation with traditional, face-to-face consultation in the management of orthopaedic conditions were included. The primary outcome measures were patient and physician preference and satisfaction. Secondary outcomes included patient length of visit, healthcare costs, ROM, pain, QOL, and ongoing management plans. Results A total of 13 articles meeting the eligibility criteria were included for systematic review and 8 for meta-analysis. There was no significant difference in patient satisfaction, length of visit, or time spent with the physician between the telemedicine and in-office control group. The mean difference of patient preference for telemedicine was significantly higher in the telemedicine group compared to the in-office visit group (OR 1.44, 95% CI 1.12–1.87, p = 0.005). Discussion Telemedicine was not inferior to face-to-face office visits in regard to patient and physician preference and satisfaction. Therefore, it would be an effective adjunct to face-to-face office visits, serving as a mechanism of triage and long-term continuity of care.

Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review

2020 ◽  
Vol 34 (8) ◽  
pp. 929-941 ◽  
Author(s):  
Bernadette Mazurek Melnyk ◽  
Stephanie A. Kelly ◽  
Janna Stephens ◽  
Kerry Dhakal ◽  
Colleen McGovern ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Physical Health ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Well Being ◽  
Cochrane Library ◽  
Lifestyle Behaviors ◽  
Inclusion Criteria ◽  
Exclusion Criteria

Objective: This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors. Data Source: A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library. Study Inclusion and Exclusion Criteria: Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers. Data Extraction: Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence. Data Synthesis: Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed. Results: Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity. Conclusion: Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.

scholarly journals Mindfulness-Based Interventions for People with Schizophrenia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (13) ◽  
pp. 4690 ◽  
Author(s):  
Ricardo M. Hodann-Caudevilla ◽  
Cintia Díaz-Silveira ◽  
Francisco A. Burgos-Julián ◽  
Miguel A. Santed
Keyword(s):  
Systematic Review ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Positive Symptoms ◽  
Clinical Parameters ◽  
Randomized Controlled ◽  
Functioning Level

(1) Background: There is increasing interest in the practice of mindfulness-based interventions (MBIs) to treat people with schizophrenia, as evidenced by the publication of different randomized controlled trials (RCTs). However, no meta-analysis of RCTs has been carried out to date with the exclusive inclusion of this type of interventions. (2) Objective: To analyze empirical evidence regarding the effectiveness of MBIs for the improvement of clinical parameters associated with schizophrenia. Method: A systematic review and meta-analysis was conducted of RCTs published in the databases PsycINFO, PubMed, WOS, and Cochrane Library. (3) Results: A total of 10 articles (n = 1094) fulfilled the criteria for inclusion in the review. The analysis of these studies suggests that MBIs combined with standard interventions are able to generate significant improvements in a variety of clinical schizophrenia-related parameters, such as the intensity of overall symptomatology (g = 0.72), positive symptoms (g = 0.32), negative symptoms (g = 0.40), functioning level (g = 1.28), and awareness of illness (g = 0.65). (4) Conclusions: There is evidence that supports the effectiveness and safety of MBIs for the treatment of people with schizophrenia. The results obtained by MBIs are comparable to those obtained by cognitive-behavioral therapy for psychosis. However, given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution.

scholarly journals Effects of cognitive behavioral therapy on anxiety and depression in patients with chronic obstructive pulmonary disease:A Meta-analysis and Systematic Review

2019 ◽  
Author(s):  
Xuemei Zhang ◽  
Changchun Yi ◽  
Wuguo Tian ◽  
Dongbing Lu ◽  
Xiumu Yang
Keyword(s):  
Systematic Review ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Cochrane Library ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Depression And Anxiety ◽  
Short Period

Abstract Symptoms such as depression and anxiety are common psychiatric symptoms in patients with chronic obstructive pulmonary disease (COPD). Cognitive-behavioral therapy (CBT) is still controversial in the treatment of anxiety and depression in patients with COPD. We conducted a meta-analysis and systematic review to evaluate the effect of CBT on anxiety and depression in patients with COPD, with a view to providing some guidance for clinical application.Materials and Methods Computer search Web of Science, EMbase, PubMed, Cochrane Library, search time limit from the establishment of the library to August 2019.Collect the randomized controlled trial (RCT) for this topic. Two investigators independently screened the literature according to inclusion and exclusion criteria, extracted the data, and assessed the risk of bias in the included studies. Meta analysis using RevMan5.3 software.Results A total of 10 studies were included in a total of 1278 patients. Meta-analysis shows that cognitive behavioral therapy can improve depression and anxiety in patients with COPD. Subgroup analysis showed that intervention time ≥ 8 weeks had significant differences in improving anxiety, while intervention time <8weeks had significant differences in improving depression.Conclusion Cognitive-behavioral therapy can improve depression in COPD patients in a short period of time, and it takes longer to improve anxiety. Therefore, clinical practice can choose the appropriate intervention time according to the patient's psychological condition.

Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

2020 ◽  
Vol 25 (6) ◽  
pp. 2177-2192 ◽  
Author(s):  
Ilky Pollansky Silva e Farias ◽  
Simone Alves de Sousa ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Bianca Marques Santiago ◽  
Antonio Carlos Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Caries Experience ◽  
Institutionalized Elderly ◽  
Periodontal Status

Abstract This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

A Meta Analytic Review of the Relationship between Emotional Intelligence and Leadership Effectiveness

2019 ◽  
Vol 118 (9) ◽  
pp. 118-126
Author(s):  
Augusty P. A ◽  
Jain Mathew
Keyword(s):  
Systematic Review ◽  
Emotional Intelligence ◽  
Direct Relationship ◽  
Effective Leadership ◽  
Leadership Effectiveness ◽  
Meta Analysis ◽  
Correlation Coefficients ◽  
Review Of Literature ◽  
Analytic Review ◽  
The Relationship

The study evaluates the relationship between Emotional Intelligence and Leadership Effectiveness through a Systematic Review of Literature. The relationship has been evaluated in two steps. First, a Systematic review of literature was done to provide a theoretical framework to link the dimensions of Emotional Intelligence to the elements of effective leadership. Meta-analysis was then used to consolidate empirical evidence of the relationship. The studies for the meta-analysis were sourced from Pro Quest and EBSCO and the correlation coefficients of the studies were analysed. Only articles that presented the direct relationship between the variables were included in the study. The results of the analysis revealed a strong, statistically significant relationship between emotional intelligence and effective leadership. The findings of the study provide evidence for the proposition that Emotional Intelligence and Leadership Effectiveness are interrelated.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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