539 - The association between olfactory dysfunction and psychiatric disorders

It is known that olfactory dysfunction occurs early in neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases and frontotemporal dementia (FTD). Dementia and psychiatric disorders share a number of clinical features, such as psychosis and depression. As such, misdiagnoses across these conditions are not uncommon. A variety of studies show smell dysfunction in schizophrenia, but little is known about other psychiatric disorders. In order to verify the link between olfaction and psychiatric disorders, a medical literature search was carried out in may 2021 using PubMed, and Cochrane Library, including the terms “olfaction” and “olfactory dysfunction” combined individually with “psychiatric disorder” and “depression”. Systematic reviews and meta-analyses written in English from 1991 to 2021 were included. Even thought one review suggested that patients with depression have reduced olfactory performance when compared with healthy, results show studies with different methodology and design which makes it difficult to reach definitive conclusions as how and if olfactory functioning is related to depression. Further studies with the same methodology that examines and separates central and peripheral olfactory processing are needed. Another review showed robust olfactory deficits in schizophrenia and at-risk youths, what indicates that olfactory measures may be a useful marker of schizophrenia risk status. Finally, a systematic review compared olfactory function in FTD, depression, schizophrenia and bipolar disorder. Results revealed that odor identification but not discrimination was severely impaired in FTD, both were impaired in schizophrenia, while no olfactory impairments were observed in depression. Findings in bipolar disorder were mixed. This review showed that testing odor identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. It is possible to conclude that olfactory dysfunction occurs in schizophrenia and dementia but not in depression.

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Smartphone-Based Self-Monitoring, Treatment, and Automatically Generated Data in Children, Adolescents, and Young Adults With Psychiatric Disorders: Systematic Review (Preprint)

10.2196/preprints.17453 ◽

2019 ◽

Cited By ~ 1

Author(s):

Sigurd Melbye ◽

Lars Vedel Kessing ◽

Jakob Eyvind Bardram ◽

Maria Faurholt-Jepsen

Keyword(s):

Systematic Review ◽

Young Adults ◽

Psychiatric Disorders ◽

Literature Search ◽

Risk Of Bias ◽

Smartphone App ◽

Controlled Trials ◽

Self Monitoring ◽

Randomized Controlled ◽

Meta Analyses

BACKGROUND Psychiatric disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning smartphone-based monitoring and treatment in this population has been published. OBJECTIVE This systematic review aims at describing the following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies. METHODS We conducted a systematic literature search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically assessed. RESULTS A total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion. These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants’ adherence to self-monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials, the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at high risk of bias in several areas. CONCLUSIONS Smartphones hold great potential as a modern, widely available technology platform to help diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses.

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Gallbladder Retrieval From Epigastric Versus Umbilical Port in Laparoscopic Cholecystectomy: A PRISMA-Compliant Meta-Analysis

Surgical Innovation ◽

10.1177/1553350619890719 ◽

2019 ◽

Vol 27 (2) ◽

pp. 150-159

Author(s):

Francesco Mongelli ◽

Davide La Regina ◽

Irin Zschokke ◽

Marcello Ceppi ◽

Antonjacopo Ferrario di Tor Vajana ◽

...

Keyword(s):

Postoperative Pain ◽

Literature Search ◽

Operative Time ◽

Meta Analysis ◽

Cochrane Library ◽

Trocar Site ◽

First Choice ◽

Significant Difference ◽

Meta Analyses ◽

Adequate Data

Purpose. To date, no evidence supports the retrieval of the gallbladder through a specific trocar site, and this choice is left to surgeons’ preference. The aim of this meta-analysis was to investigate the influence of the trocar site used to extract the gallbladder on postoperative outcomes. Methods. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search of PubMed, Google Scholar, Cochrane Library, and EMBASE databases was performed. Terms used were: (“gallbladder” OR “cholecystectomy”) AND “umbilical” AND (“epigastric” OR “subxiphoid”). Randomized trials comparing the gallbladder retrieval from different trocar sites were considered for further analysis. Results. Literature search revealed 145 articles, of which 7 matched inclusion criteria and reported adequate data about postoperative pain, operative time, port-site infections, and hernias. A total of 876 patients were included, and the gallbladder was extracted through epigastric or umbilical trocar site in 441 and in 435 patients, respectively. A statistically significant difference among groups was noted in terms of postoperative pain at 1, 6, 12, and 24 hours in favor of the umbilical trocar site ( P < .001). No significant differences were noted in postoperative hernia and infection rate, nor in terms of operative time. Conclusions. This meta-analysis shows a statistically significant reduction in terms of postoperative pain at 1, 6, 12, and 24 hours after surgery when the gallbladder is extracted through the umbilical port. Retrieval time, infections, and hernias rate implicate no contraindication for the choice of a specific trocar site to extract specimens. Despite limitations of this study, the umbilical trocar should be favored as the first choice to retrieve the gallbladder.

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Synthesizing medical evidence: systematic reviews and metaanalyses

Neurosurgical FOCUS ◽

10.3171/foc.2005.19.4.6 ◽

2005 ◽

Vol 19 (4) ◽

pp. 1-21 ◽

Cited By ~ 21

Author(s):

Fred G. Barker ◽

Bob S. Carter

Keyword(s):

Systematic Reviews ◽

Literature Search ◽

Medical Literature ◽

Research Question ◽

Medical Knowledge ◽

Medical Evidence ◽

Internet Resources ◽

Meta Analyses

Systematic reviews and metaanalyses have become increasingly popular ways of summarizing, and sometimes extending, existing medical knowledge. In this review the authors summarize current methods of performing meta-analyses, including the following: formulating a research question; performing a structured literature search and a search for trials not published in the formal medical literature; summarizing and, where appropriate, combining results from several trials; and reporting and presenting results. Topics such as cumulative and Bayesian metaanalysis and metaregression are also addressed. References to textbooks, articles, and Internet resources are also provided. The goal is to assist readers who wish to perform their own metaanalysis or to interpret critically a published example.

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Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.096594 ◽

2012 ◽

Vol 200 (2) ◽

pp. 97-106 ◽

Cited By ~ 204

Author(s):

Stefan Leucht ◽

Sandra Hierl ◽

Werner Kissling ◽

Markus Dold ◽

John M. Davis

Keyword(s):

Psychiatric Disorders ◽

General Medicine ◽

Effect Sizes ◽

Cochrane Library ◽

Primary Efficacy ◽

Societal Values ◽

Psychiatric Drugs ◽

Psychotropic Agents ◽

Meta Analyses ◽

The Cochrane Library

BackgroundThe efficacy of psychopharmacological treatments has been called into question. Psychiatrists are unfamiliar with the effectiveness of common medical drugs.AimsTo put the efficacy of psychiatric drugs into the perspective of that of major medical drugs.MethodWe searched Medline and the Cochrane Library for systematic reviews on the efficacy of drugs compared with placebo for common medical and psychiatric disorders, and systematically presented the effect sizes for primary efficacy outcomes.ResultsWe included 94 meta-analyses (48 drugs in 20 medical diseases, 16 drugs in 8 psychiatric disorders). There were some general medical drugs with clearly higher effect sizes than the psychotropic agents, but the psychiatric drugs were not generally less efficacious than other drugs.ConclusionsAny comparison of different outcomes in different diseases can only serve the purpose of a qualitative perspective. The increment of improvement by drug over placebo must be viewed in the context of the disease's seriousness, suffering induced, natural course, duration, outcomes, adverse events and societal values.

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A meta-analysis comparing cognitive function across the mood/psychosis diagnostic spectrum

Psychological Medicine ◽

10.1017/s0033291720002020 ◽

2020 ◽

pp. 1-9

Author(s):

Amy J. Lynham ◽

Siân L. Cleaver ◽

Ian R. Jones ◽

James T. R. Walters

Keyword(s):

Bipolar Disorder ◽

Schizoaffective Disorder ◽

Literature Search ◽

Cognitive Impairments ◽

Meta Analysis ◽

Cognitive Variables ◽

Single Category ◽

Meta Analyses ◽

The Relationship ◽

Better Than

Abstract Background The nature and degree of cognitive impairments in schizoaffective disorder is not well established. The aim of this meta-analysis was to characterise cognitive functioning in schizoaffective disorder and compare it with cognition in schizophrenia and bipolar disorder. Schizoaffective disorder was considered both as a single category and as its two diagnostic subtypes, bipolar and depressive disorder. Methods Following a thorough literature search (468 records identified), we included 31 studies with a total of 1685 participants with schizoaffective disorder, 3357 with schizophrenia and 1095 with bipolar disorder. Meta-analyses were conducted for seven cognitive variables comparing performance between participants with schizoaffective disorder and schizophrenia, and between schizoaffective disorder and bipolar disorder. Results Participants with schizoaffective disorder performed worse than those with bipolar disorder (g = −0.30) and better than those with schizophrenia (g = 0.17). Meta-analyses of the subtypes of schizoaffective disorder showed cognitive impairments in participants with the depressive subtype are closer in severity to those seen in participants with schizophrenia (g = 0.08), whereas those with the bipolar subtype were more impaired than those with bipolar disorder (g = −0.23) and less impaired than those with schizophrenia (g = 0.29). Participants with the depressive subtype had worse performance than those with the bipolar subtype but this was not significant (g = 0.25, p = 0.05). Conclusion Cognitive impairments increase in severity from bipolar disorder to schizoaffective disorder to schizophrenia. Differences between the subtypes of schizoaffective disorder suggest combining the subtypes of schizoaffective disorder may obscure a study's results and hamper efforts to understand the relationship between this disorder and schizophrenia or bipolar disorder.

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Smartphone-Based Self-Monitoring, Treatment, and Automatically Generated Data in Children, Adolescents, and Young Adults With Psychiatric Disorders: Systematic Review

JMIR Mental Health ◽

10.2196/17453 ◽

2020 ◽

Vol 7 (10) ◽

pp. e17453

Author(s):

Sigurd Melbye ◽

Lars Vedel Kessing ◽

Jakob Eyvind Bardram ◽

Maria Faurholt-Jepsen

Keyword(s):

Systematic Review ◽

Young Adults ◽

Psychiatric Disorders ◽

Literature Search ◽

Risk Of Bias ◽

Smartphone App ◽

Controlled Trials ◽

Self Monitoring ◽

Randomized Controlled ◽

Meta Analyses

Background Psychiatric disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning smartphone-based monitoring and treatment in this population has been published. Objective This systematic review aims at describing the following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies. Methods We conducted a systematic literature search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically assessed. Results A total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion. These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants’ adherence to self-monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials, the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at high risk of bias in several areas. Conclusions Smartphones hold great potential as a modern, widely available technology platform to help diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses.

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Management of ureteric avulsion during ureteroscopy: a systematic review and our experience

African Journal of Urology ◽

10.1186/s12301-020-00078-x ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

P. Ashwin Shekar ◽

Gaurav Kochhar ◽

Dinesh Reddy ◽

Anuj Dumra

Keyword(s):

English Language ◽

Literature Search ◽

Long Term Results ◽

Cochrane Library ◽

Management Options ◽

Intraoperative Complication ◽

Distal Ureter ◽

The Common ◽

Meta Analyses

Abstract Background Ureteric avulsion is a disastrous intraoperative complication that can happen to any urologist during a common endoscopic procedure like ureteroscopy. The aim of this study is to evaluate the various management options of ureteric avulsion during ureteroscopy and also report our relevant experience in this topic. Results The Preferred Reporting Items for Systematic Reviews and Meta-Analyses of existing literature in English language was used in the period 1967–2019 with a literature search in PubMed, Cochrane Library and Google Scholar. Forty-three patients in twenty-three articles who had undergone management of ureteric avulsion during ureteroscopy were identified for review. There were 15 proximal, 19 two-point (“scabbard”) and 9 distal avulsions. All distal avulsions were managed successfully with ureteroneocystostomies or Boari flaps. Boari flaps and ureteropyelostomy with ureterovesicostomy were the common procedures used for proximal avulsions. Proximal avulsions had more varied outcomes with salvage rates of 86.9%. Procedures which incorporated the avulsed distal ureter for reconstruction had poor results. Conclusion Management of ureteric avulsion during ureteroscopy is a surgical challenge. While management of distal avulsions is straightforward in the form of ureteroneocystostomies and has uniformly good results in most hands, proximal avulsions need expertise in management and choosing ideal reconstruction, with variable results following reconstruction. Extended Boari flaps, ileal ureter and autotransplantation are good options for proximal avulsions. Reconstruction using the distal avascular ureter should be avoided for better long-term results.

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MECHANISMS IN ENDOCRINOLOGY: Maternal thyroid dysfunction during pregnancy and behavioural and psychiatric disorders of children: a systematic review

Acta Endocrinologica ◽

10.1530/eje-16-0860 ◽

2017 ◽

Vol 177 (5) ◽

pp. R261-R273 ◽

Cited By ~ 20

Author(s):

Dagnachew Muluye Fetene ◽

Kim S Betts ◽

Rosa Alati

Keyword(s):

Thyroid Hormone ◽

Psychiatric Disorders ◽

Thyroid Dysfunction ◽

Hormone Level ◽

Later Life ◽

Thyroid Hormone Level ◽

Cochrane Library ◽

Developmental Problems ◽

Maternal Thyroid ◽

Meta Analyses

Background Maternal thyroid dysfunction during pregnancy may lead to persistent neurodevelopmental disorders in the offspring appearing in later life. This study aimed to review the available evidence concerning the relationship between maternal thyroid status during pregnancy and offspring behavioural and psychiatric disorders. Methods Systematic electronic database searches were conducted using PubMed, Embase, PsycNET, Scopus, Google Scholar and Cochrane library. Studies including gestational thyroid dysfunction as the exposure and offspring behavioural and psychiatric disorders as the outcome were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed and, after thorough screening by two independent reviewers, 13 articles remained eligible for inclusion in this study. Results Indicators of maternal thyroid dysfunction, including low and high thyroid hormone level and autoimmune thyroiditis, during early pregnancy, were found to be associated with several offspring behavioural and psychiatric disorders such as attention deficit hyperactivity disorder (ADHD), autism, pervasive developmental problems, externalising behaviour, in addition to epilepsy and seizure. The majority of associations were found with low maternal thyroid hormone level. Conclusion Maternal thyroid function during pregnancy, particularly hypothyroidism, is associated with behavioural and psychiatric disorders in children. Further studies are needed with a capacity to adjust for a fuller range of confounding factors.

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521 - The link between olfactory dysfunction and dementia: the road so far.

International Psychogeriatrics ◽

10.1017/s1041610221002167 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 69-70

Author(s):

Marcela Leão Petersen ◽

Monia Bresolin ◽

Ariane Madruga Monteiro

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Neurodegenerative Diseases ◽

Neurodegenerative Disorder ◽

Functional Neuroimaging ◽

Olfactory Dysfunction ◽

Cochrane Library ◽

Meta Analyses ◽

Smell Tests

Dementia is characterized by the presence of progressive cognitive impairment losses in the individual’s social and occupational activities. Its etiological diagnosis has therapeutic and prognostic implications. Although its definitive diagnosis depends on neuropathological analysis, detailed anamnesis, physical and neuropsychological tests; biochemical and neuroimaging exams may enable a greater accuracy. Technological innovations using structural and functional neuroimaging methods, as well as biology and molecular genetics techniques, have presented perspectives for the early diagnosis of dementias, particularly Alzheimer’s disease (AD). However, such techniques burden the diagnostic investigation, making its practice unfeasible most the times. The probable link between neurodegenerative diseases and impaired olfactory dysfunction has long been studied. It is suggested that smell tests can be used in dementia’s early detection and differential diagnosis, reducing costs and facilitating the establishment of appropriate treatment. In order to verify the validity of this information, a medical literature search was carried out in may 2021 using PubMed and Cochrane Library, including the terms “olfaction” and “olfactory dysfunction” combined individually with “neurodegenerative disorder”, “dementia” and “Alzheimer’s disease”. Only systematic reviews and meta-analyses written in English from 1991 to 2021 were included. Results show that olfactory impairment in neurodegenerative diseases worsens progressively as patients progress from mild cognitive impairment to AD. It suggests that odor tests could potentially identify AD in the preclinical stages. Although, rigorously designed longitudinal cohort studies are necessary to clarify the value of olfactory identification testing in predicting the onset of AD and its value as an early marker of cognitive decline. In addition, AD patients are more impaired on odor identification and recognition tasks and Parkinson’s Disease (PD) patients on odor detection thresholds tasks, what suggests that PD patients are more impaired on low-level perceptual olfactory tasks whereas AD patients are more strongly impaired on higher-order olfactory tasks involving specific cognitive processes. The results suggest smell tests are a cheaper, simpler to apply and a promising weapon for detecting individuals at risk of dementia.

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The use of atypical antipsychotics in the therapy of depressive episodes in patients with bipolar disorder

Medical Herald of the South of Russia ◽

10.21886/2219-8075-2021-12-3-32-35 ◽

2021 ◽

Vol 12 (3) ◽

pp. 32-35

Author(s):

E. A. Strel’tsov

Keyword(s):

Bipolar Disorder ◽

Literature Search ◽

Atypical Antipsychotics ◽

Web Of Science ◽

Rating Scale ◽

Bipolar Depression ◽

Systematic Literature Search ◽

Severity Scale ◽

Meta Analyses ◽

Depressive Episodes

This literature review addresses the effi cacy and safety of atypical antipsychotics in patients with bipolar depression. Th e results of randomized studies and systematic meta-analyses of recent years were revised in detail. The effi cacy of the drug intake was reviewed for the following key research points: Clinical General Impression of Condition Severity Scale (CGI-S) and Montgomery-Asberg Depression Rating Scale (MADRS). A systematic literature search was carried out using Scopus, Web of Science, MedLine, elibrary, and other databases.

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