A Systematic Review of Treatment Interventions for Individuals With Intellectual Disability and Trauma Symptoms: A Review of the Recent Literature

2020 ◽  
pp. 152483802096021 ◽  
Author(s):  
Gary Byrne
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Treatment Options ◽  
Small Sample ◽  
Therapeutic Interventions ◽  
Trauma Symptoms ◽  
Post Traumatic Stress ◽  
High Quality Research ◽  
Associated Symptoms ◽  
Adults And Children

Individuals with intellectual disabilities (IDs) are at increased susceptibility to adverse life experiences and trauma sequelae. There is a disparate range of therapeutic interventions for post-traumatic stress disorder (PTSD) and associated symptoms. This systematic review aimed to appraise the effectiveness of both cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) for PTSD and associated symptoms for both adults and children with mild, moderate, or severe intellectual delay. A systematic search, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of the PsychInfo, PubMed, Cochrane Database of Systematic Reviews, and MEDLINE databases were performed, and all relevant articles published between 2010 and March 2020 were included. A total of 11 articles were included, eight that focused on EMDR and three on CBT. The methodological quality of many of these articles was generally weak. Tentative findings suggest that EMDR and CBT are both acceptable and feasible treatment options among adults and children with varying levels of intellectual delay, but no firm conclusions can be drawn regarding effectiveness due to small sample sizes, lack of standardized assessment, and a paucity of methodological rigorous treatment designs. This review highlights the continued use of therapeutic approaches with clients presenting with IDs and PTSD. It adds to the extant literature by providing an expansive and broad overview of the current effectiveness of both EMDR and CBT. Further high-quality research is needed to provide more conclusive findings regarding treatment effectiveness and modifications to treatment needed with this population.

scholarly journals Psychedelic-Assisted Psychotherapy for Post-Traumatic Stress Disorder, Anxiety Disorders, Mood Disorders, or Substance Use Disorders

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Yi-Sheng Chao ◽  
Jennifer Horton
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Small Sample ◽  
Mental Illnesses ◽  
Controlled Trials ◽  
Motivational Enhancement Therapy ◽  
Post Traumatic Stress ◽  
Randomized Controlled

Two systematic reviews, 3 randomized controlled trials, and 2 single-arm safety trials were identified that evaluated several combinations of psychedelic-assisted psychotherapy. Psilocybin was the psychedelic most tested. Other psychedelics identified in the systematic reviews and primary studies were 3,4-methylenedioxymethamphetamine (or MDMA), lysergic acid diethylamide (or LSD), ayahuasca (also named N,N-dimethyltryptamine [or DMT]), ibogaine, ketamine, and nitrous oxide. Manualized therapy (not defined) and non-directive support (not defined) were the psychotherapies most studied in the relevant primary studies in the 2 systematic reviews. Other psychotherapies identified included integrative psychotherapy, cognitive behavioural therapy (CBT), CBT and motivational enhancement therapy, psychosocial interventions, non-directive support, group talk therapy, and guided support. Clinical effectiveness lasting weeks to months was observed in 1 systematic review that reviewed primary studies examining various combinations of psychedelics and psychotherapy in patients with various mental health conditions. Significant improvement in symptom scores related to mental illnesses and no serious and long-term adverse events were reported in the other systematic review. Various combinations of psychedelics and psychotherapies were evaluated in 3 randomized controlled trials (RCTs) and 2 safety studies. Ketamine-assisted psychotherapies were associated with improvements in the symptoms related to substance use disorder in 2 RCTs. Psilocybin-assisted psychotherapy was reported to be efficacious in treating MDD in 1 RCT. No serious adverse effects were reported in the RCTs or in 2 safety trials using MDMA-assisted psychotherapy. There were several limitations to the included studies, including small sample sizes (less than 20 in the majority of primary studies), relatively short follow-ups (1 week to 3 years; less than or equal to 1 year in 27 out of 31 relevant publications), differences in psychotherapy classification between systematic reviews, considerable heterogeneity between studies, and unclear generalizability and availability of the interventions in Canadian contexts. Therefore, findings should be interpreted with caution. No relevant guidelines were identified.

scholarly journals Therapeutic interventions for COVID-19: a living overview of reviews

2020 ◽  
Vol 14 ◽  
pp. 175346662097602
Author(s):  
Malahat Khalili ◽  
Maryam Chegeni ◽  
Sara Javadi ◽  
Mehrdad Farokhnia ◽  
Hamid Sharifi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Treatment Options ◽  
Ventilatory Support ◽  
Population Level ◽  
Therapeutic Interventions ◽  
Measurement Tool ◽  
Overview Of Reviews ◽  
Drug Classes ◽  
Cochrane Database

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but safe and effective treatment options remain unavailable. Numerous systematic reviews of varying qualities have tried to summarize the evidence on the available therapeutic interventions for COVID-19. This overview of reviews aims to provide a succinct summary of the findings of systematic reviews on different pharmacological and non-pharmacological therapeutic interventions for COVID-19. Methods: We searched PubMed, Embase, Google Scholar, Cochrane Database of Systematic Reviews, and WHO database of publications on COVID-19 from 1 December 2019 through to 11 June 2020 for peer-reviewed systematic review studies that reported on potential pharmacological or non-pharmacological therapies for COVID-19. Quality assessment was completed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) measure. Results: Out of 816 non-duplicate studies, 45 were included in the overview. Antiviral and antibiotic agents, corticosteroids, and anti-malarial agents were the most common drug classes used to treat COVID-19; however, there was no direct or strong evidence to support their efficacy. Oxygen therapy and ventilatory support was the most common non-pharmacological supportive care. The quality of most of the included reviews was rated as low or critically low. Conclusion: This overview of reviews demonstrates that although some therapeutic interventions may be beneficial to specific subgroups of COVID-19 patients, the available data are insufficient to strongly recommend any particular treatment option to be used at a population level. Future systematic reviews on COVID-19 treatments should adhere to the recommended systematic review methodologies and ensure that promptness and comprehensiveness are balanced. The reviews of this paper are available via the supplemental material section.

scholarly journals S3. DOES SWITCHING OR AUGMENTING HELP WITH ANTIPSYCHOTIC-RELATED SEXUAL DYSFUNCTION: SYSTEMATIC REVIEW

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S30-S31
Author(s):  
Kirsty Allen ◽  
Alan Baban ◽  
Jasna Munjiza ◽  
Sofia Pappa
Keyword(s):  
Systematic Review ◽  
Sexual Dysfunction ◽  
Small Sample Size ◽  
Treatment Options ◽  
Surrogate Marker ◽  
Small Sample ◽  
Quality Data ◽  
Future Research ◽  
High Quality ◽  
High Quality Research

Abstract Background Sexual dysfunction is one of the most frequently occurring side-effects of antipsychotic medication, impacting both quality of life and adherence to treatment. Despite this, limited evidence-based guidance on treatment options is available. The aim of this systematic review was to synthesize and analyze the evidence on the management of antipsychotic-related sexual dysfunction, specifically taking note of the more recently developed antipsychotics that have been incorporated Methods EMBASE, Medline, and PsychINFO databases were searched using search terms related to sexual or erectile dysfunction, treatments, and antipsychotics. 2 reviewers independently assessed papers for the inclusion criteria for randomized controlled trials (RCTs) of treatments for antipsychotic-related sexual dysfunction, including adjunctive medications and a switch of antipsychotic. Studies were excluded if participants did not have recorded sexual dysfunction at baseline. Results The primary outcome measure was any change in sexual function. Results 6 RCTs were identified, all of which investigated different interventions; hence, it was not possible to synthesize the data quantitatively. Results were overall limited by small sample size, brief treatment duration, and the potential for bias. 2 studies, one assessing adjunctive sildenafil and the other adjunctive aripiprazole, reported a reduction in antipsychotic-related sexual dysfunction. Discussion Due to the lack of high-quality data, no clinical recommendations can be made. Our findings highlight the paucity of high-quality research in this area, and conjecture that it may be difficult to recruit participants with antipsychotic-related sexual dysfunction. Future research may be necessary to unlock and address these difficulties. Furthermore, fully powered future studies should focus on the management of sexual dysfunction rather than the surrogate marker of hyperprolactinemia.

scholarly journals Appraisal of systematic reviews on interventions for postpartum depression: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryan Chow ◽  
Eileen Huang ◽  
Allen Li ◽  
Sophie Li ◽  
Sarah Y. Fu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
A Priori ◽  
Behavioural Therapy ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Cochrane Library ◽  
Measurement Tool

Abstract Background Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. Methods An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. Results Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, − 0.09 to 0.34), or source of funding (p = 0.19). Conclusion Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.

Can Exergaming Promote Physical Fitness and Physical Activity?

Gamification ◽  
2015 ◽  
pp. 2022-2039 ◽  
Author(s):  
Tuomas Kari
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Current Evidence ◽  
Activity Levels ◽  
High Quality Research ◽  
Significant Health

This systematic review of systematic reviews evaluates the effectiveness of exergaming on physical fitness and physical activity. A systematic literature search was conducted on 10 databases, and 1040 articles were identified. Sixty-eight articles were found potentially relevant and were selected for closer screening. Cross-referencing was conducted to find other potentially relevant articles. The quality of all relevant articles was evaluated using the AMSTAR tool. After all the duplicates were removed and inclusion, exclusion, and quality criteria were implemented, six articles remained for review. The results indicate that exergaming is generally enjoyed and can evoke some benefits for physical fitness and physical activity, but the current evidence does not support the ability of exergaming to increase physical fitness or physical activity levels sufficiently for significant health benefits. This systematic review also revealed several gaps in previous research. Additional high-quality research and systematic reviews concerning exergaming are needed.

Promoting Physical Activity and Fitness with Exergames

2016 ◽  
pp. 225-245 ◽  
Author(s):  
Tuomas Kari
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Current Evidence ◽  
Activity Levels ◽  
High Quality Research ◽  
Significant Health

This updated systematic review of systematic reviews evaluates the effectiveness of exergaming on physical fitness and physical activity. A systematic literature search was conducted on 10 databases, first in 2014 and then repeated in 2016. In total, 1040 and 287 articles were identified. 68 and 31 articles were found potentially relevant and selected for closer screening. The quality of all relevant articles was evaluated using the AMSTAR tool. After the duplicates were removed and inclusion, exclusion, and quality criteria were implemented, six and three articles remained for review. The results indicate that exergaming is generally enjoyed and can evoke some benefits for physical fitness and physical activity, but the current evidence does not support the ability of exergaming to increase physical fitness or physical activity levels sufficiently for significant health benefits. This systematic review also revealed gaps in previous research. Additional high-quality research and systematic reviews concerning exergaming are needed.

scholarly journals Identifying Trajectories and Predictors of Response to Psychotherapy for Post-Traumatic Stress Disorder in Adults: A Systematic Review of Literature

2019 ◽  
pp. 070674371987560 ◽  
Author(s):  
Michelle Dewar ◽  
Alison Paradis ◽  
Christophe A. Fortin
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Individual Variability ◽  
Therapeutic Interventions ◽  
Valuable Insight ◽  
Post Traumatic Stress ◽  
Related Factors ◽  
Post Traumatic

Objective: There exists considerable individual variability in the development and progression of pathological stress reactions after experiencing trauma, as well as in individuals’ response to psychological interventions. Yet until recently, such individual differences had not been considered when evaluating the efficacy of therapeutic interventions for post-traumatic stress disorder (PTSD). This systematic review aims to examine the emerging literature on this subject and, specifically, to identify trajectories and predictors of psychotherapeutic response in adults with PTSD. Method: Four databases were searched using specific keywords without date or language restrictions. For each study, independent reviewers systematically evaluated whether it met eligibility criteria and assessed risk of bias. For included studies, reviewers completed data extraction using standard formats. Those examining how subgroups of adults respond to therapy for clinical PTSD using trajectory modeling were deemed eligible. Demographic, PTSD, clinical, and trauma-related factors associated to particular trajectories were also examined. Results: Of the 1,727 papers identified, 11 were included in this analysis. Of these studies, six focused on military-related traumas and five on civilian ones. Although studies found between two and five trajectories, most supported a three-trajectory model of response categorized as responders, nonresponders, and subclinical participants. Over 22 predictors of treatment trajectories were examined. Comorbid depression, anxiety, and alcohol abuse were the strongest predictors of poor therapeutic response. Age, combat exposure, social support, and hyperarousal were moderate predictors. Conclusion: This review provides valuable insight into the treatment of PTSD, as it supports the heterogeneous trajectories of psychotherapeutic responses and provides avenues for the development of interventions that consider individual-level factors in treatment response.

scholarly journals Trigger Point Injections for Chronic Non-Malignant Musculoskeletal Pain: A Systematic Review

Pain Medicine ◽  
2009 ◽  
Vol 10 (1) ◽  
pp. 54-69 ◽  
Author(s):  
N. Ann Scott ◽  
Bing Guo ◽  
Pamela M. Barton ◽  
Robert D. Gerwin
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Musculoskeletal Pain ◽  
Systematic Reviews ◽  
Trigger Point ◽  
Small Sample ◽  
Controlled Trials ◽  
Safe Procedure ◽  
Randomized Controlled ◽  
Published Evidence

ABSTRACT Objective. This systematic review assessed the available published evidence on the efficacy and safety of using trigger point injection (TPI) to treat patients with chronic non-malignant musculoskeletal pain that had persisted for at least 3 months. Methods. All published systematic reviews or randomized controlled trials detailing the use of TPI in patients with chronic, non-malignant musculoskeletal pain (persisting for >3 months) were identified by systematically searching literature databases and the Websites of various health technology assessment agencies, research registers, and guidelines sites up to July 2006. Results. Although no systematic reviews were identified, 15 peer-reviewed randomized controlled trials met the inclusion criteria. However, deficiencies in reporting, small sample sizes, and marked inter-study heterogeneity precluded a definitive synthesis of the data. TPI is a safe procedure when used by clinicians with appropriate expertise and training. It relieved symptoms when used as a sole treatment for patients with chronic head, neck, shoulder, and back pain or whiplash syndrome, regardless of the injectant used, and may be a useful adjunct to intra-articular injection in the treatment of osteoarthritis pain. Although the addition of TPI to stretching exercises augments treatment outcomes, this was also true of other therapies such as ultrasound and laser. Conclusion. The efficacy of TPI is no more certain than it was a decade ago as, overall, there is no clear evidence of either benefit or ineffectiveness. The only advantage of injecting anesthetic into trigger points may be to reduce the pain of the needling process, which may not be an insignificant benefit.

scholarly journals The Evidence-Base for Psychodynamic Psychotherapy With Children and Adolescents: A Narrative Synthesis

2021 ◽  
Vol 12 ◽  
Author(s):  
Nick Midgley ◽  
Rose Mortimer ◽  
Antonella Cirasola ◽  
Prisha Batra ◽  
Eilis Kennedy
Keyword(s):  
Children And Adolescents ◽  
Systematic Reviews ◽  
Psychodynamic Psychotherapy ◽  
Clinical History ◽  
Evidence Base ◽  
Small Sample ◽  
Psychodynamic Therapy ◽  
Narrative Synthesis ◽  
High Quality Research ◽  
Wide Range

Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers (28 distinct studies). When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers (82 distinct studies). The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations (small sample sizes, lack of control groups etc.), and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people.

scholarly journals Clinical management of idiopathic mastalgia: a systematic review

2018 ◽  
Vol 10 (4) ◽  
pp. 312 ◽  
Author(s):  
Shazia P. Hafiz ◽  
Nicola L. P. Barnes ◽  
Cliona C. Kirwan
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Systematic Reviews ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Unknown Origin ◽  
Good Evidence ◽  
Breast Pain ◽  
Clinical Trial Registry ◽  
Receptor Modulator

ABSTRACT INTRODUCTIONIdiopathic mastalgia (benign breast pain of unknown origin) is often poorly managed because of its subjective nature and unclear aetiology. Mastalgia is a reason for up to 50% of breast outpatient referrals. Existing systematic reviews discuss dated treatment options that provide limited symptomatic relief. METHODSA systematic review was conducted for aetiology and treatment of idiopathic mastalgia in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidance. Databases such as PubMed, MEDLINE, Cochrane Database and the Clinical Trial Registry were searched (February 2016). RESULTSReassurance plus bra-fitting advice provides relief for most women. If symptoms persist, addition of topical non-steroidal anti-inflammatory drugs (NSAIDs) provides relief in 70–92% of women. There is some benefit in reducing dietary coffee and fat intake. Medical treatments have serious side-effects (often androgenic or menopausal) and should be considered only in cases resistant to simpler measures. Dopamine agonists are useful, but less effective than endocrine treatments such as Danazol or Tamoxifen. Of the Selective Oestrogen Receptor Modulator drugs, Ormeloxifene appears most effective, but is not licenced in the United Kingdom. Relaxation therapy, acupuncture and kinesiology may be useful but currently lack good evidence of effectiveness. DISCUSSIONFirst-line management of breast pain should be explanation, reassurance and a bra-fitting advice. Subsequent drug therapy should be balanced against its side-effects; topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects. Newer agents (Ormeloxifene) currently being used for mastalgia in India could be considered in the developed world.

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